Comparison of quadrant-specific breast cancer incidence trends in the United States and England between 1975 and 2013

Abstract

Background: UK breast cancer incidence rates suggest that upper outer quadrant (UOQ) cancers have risen disproportionately compared with other areas over time. We aimed to provide a comparison of the trend in quadrant-specific breast cancer incidence between the United States (US) and England, and determine whether a disproportionate UOQ increase is present.Methods: Surveillance Epidemiology and End Result (SEER) cancer registry data were obtained on 630,007 female breast cancers from 1975-2013. English cancer registry data were obtained on 1,121,134 female breast cancers from 1979-2013. Temporal incidence changes were analysed using negative binomial regression.Interaction terms determined whether incidence changes were similar between sites.Results: English breast cancer incidence in the UOQ rose significantly from 13% to 28% from 1979 to 2013 whereas no significant increase was observed among SEER data. The significant interaction between quadrant and year of diagnosis (p<0.001) in both SEER and English data indicates that breast cancer incidence in each quadrant changed at a different rate. Incidence in the UOQ rose disproportionately compared to the nipple (SEER IRR=0.81, p<0.001; England IRR=0.78, p<0.001) and axillary tail (SEER IRR=0.87, p=0.018; England IRR=0.69, p<0.001) in both SEER and England. In addition, incidence rose disproportionately in the UOQ compared to non-site specific tumours in England (Overlapping lesions IRR=0.81, p=0.002; NOS IRR=0.78, p<0.001). The proportion of non-site specific tumours was substantially higher in England than SEER throughout the study period (62% in England; 39% in SEER). Conclusions:Breast cancer incidence in the UOQ increased disproportionately compared to non-site specific tumours in England but not in SEER, likely due to the decrease in non-site specific tumours observed in England over time. There may be real differences in incidence between the two countries, possibly due to differences in aetiology, but is much more likely to be an artefact of changing data collection methods and improvements in site coding in either country.

Impact of an In Situ Component on Outcome After In-Breast Tumor Recurrence in Patients Treated with Breast-Conserving Therapy

“…For instance, among studies that consider location of IBTR, it is unclear how far a tumor must be from the tumor bed to be considered a NP 14,15,19 . The likelihood of a NP developing near the tumor bed is also significant, especially in considering that most breast cancers arise in the upper outer quadrant 36 . Furthermore, when not combined with other classification criteria such as change in histologic type, location alone may not portend a statistically significant difference in prognosis 14,37 .…”

Use of Underarm Cosmetic Products in Relation to Risk of Breast Cancer: A Case-Control Study

“…These factors explain only a small part of the etiology (Turnbull and Rahman, 2008) suggesting that environmental factors may also be relevant in the development of breast cancer (Bonefeld-Jorgensen et al, 2011, Coyle, 2004). A change in the topological distribution of mammary carcinoma since 1975 (Bright et al, 2016, Darbre, 2016, Darbre, 2009, Darbre, 2005, Darbre, 2005) towards an higher incidence in the upper outer quadrant seems to point to underarm cosmetic products (UCPs) as a potential contributor (Darbre, 2009, Darbre, 2005, Darbre, 2005, Darbre et al, 2013b). Previous studies investigating the effect of UCPs on breast cancer have shown conflicting results (McGrath, 2003, Mirick et al, 2002, Pasha et al, 2008, Rodrigues-Peres et al, 2013).…”

<p>Patterns of Chest Wall Recurrence and Suggestions on the Clinical Target Volume of Breast Cancer: A Retrospective Analysis of 121 Postmastectomy Patients</p>

“…It is reported that proportions of tumors located in the upper outer quadrant, upper inner quadrant, lower inner quadrant, and lower outer quadrant are 41.2-46.9%, 11.-13.1%, 5.6-5.8%, and 8.2-8.5%, respectively. 29 The incidence of BC is proportional to the amount of breast tissue. 30 In our study, the incidence of tumor in the upper outer quadrant is also the highest (32.1%).…”