Distinct Clinicopathological Features and Prognosis of Emerging Young-Female Breast Cancer in an East Asian Country: A Nationwide Cancer Registry-Based Study

Lin, Ching‐Hung; Chuang, Po Ya; Chiang, Chun‐Ju; Lu, Yen‐Shen; Cheng, Ann‐Lii; Kuo, Wang-Chuang; Huang, Chiun Sheng; Lai, Mei‐Shu; You, San–Lin; Tang, Chao Hsiun

doi:10.1634/theoncologist.2014-0047

Cited by 50 publications

(42 citation statements)

References 30 publications

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“…The premenopausal patients accounted for 54.55% of the total breast cancer cases, the proportion was significantly higher than that of postmenopausal patients, and that differed from the corresponding proportion in a Western population 15. This finding suggests the possibility that certain differences in the pathogenesis of breast cancer, considered to be related to ethnicity, age at menarche, marital status, number of pregnancies, number of births, and breastfeeding history 16, 17, 18, 19, may exist between premenopausal and postmenopausal patients.…”

Section: Discussionmentioning

confidence: 93%

Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

et al. 2018

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Premenopausal and postmenopausal breast cancers are considered different types. Thus, this study aimed to explore differences in risk factors, epidemiological features, clinicopathological features, and treatment modes of premenopausal breast cancer compared to postmenopausal patients in western China. This was a hospital‐based, retrospective, multicenter epidemiological study of patients with breast cancer. Using the Western China Clinical Cooperation Group database, we obtained the records of 15,389 female breast cancers between January 2010 and April 2017. These patients were divided into premenopausal and postmenopausal groups, and their risk factors, epidemiological feature, clinicopathological features, and treatment modes were compared. Chi‐square tests, t‐test, and the multivariate logistic regression analysis were applied for statistical analysis. A total of 8395 patients were categorized as premenopausal, and 6994 patients were categorized as postmenopausal. Their risk factors, epidemiological features, clinicopathological features, and treatment modes were compared. Premenopausal patients with breast cancer had a greater tumor diameter at diagnosis (P = 0.008); higher rates of estrogen receptor (ER) expression (P < 0.0001), progesterone receptor (PR) expression (P < 0.0001), negative human epidermal growth factor receptor 2 (HER2) expression (P = 0.015), and negative P53 expression (P < 0.0001); and higher proportions of receiving breast‐conserving surgery and breast reconstruction (P < 0.0001), chemotherapy (P < 0.0001), radiotherapy (P < 0.0001), and endocrine therapy (P < 0.0001). The ethnicity, age at menarche, marital status, number of pregnancies, and number of births were the risk factors for age at diagnosis of breast cancer before or after menopause in western China. We found that the fall in the fertility rate, early menarche age, married, and less breastfeeding might have increased the possibility of premenopausal breast cancer. Significant differences exist in the tumor size, hormone receptor state, HER2 expression, epidemiological features, and treatment modes between premenopausal and postmenopausal female breast cancer patients in western China. Its further implementation requires prospective clinical testing.

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Section: Discussionmentioning

confidence: 93%

Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

et al. 2018

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“…In Asia, reports have indicated that the annual incidence of breast cancer has doubled or tripled over the past two decades. In Asia, the onset of breast cancer tends to occur at a younger age and more estrogen receptor (ER) positive or progesterone receptor (PR) positive subtypes, associated with a more favorable clinical-pathological outcome [2]. The etiology of breast cancer has generally been attributed to genetic, reproductive, and hormonal factors.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and survival outcome of breast cancer in a nationwide study

et al. 2017

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Breast cancer is among the most prevalent cancers in Taiwan. The National Health Insurance database was used to identify patients with breast cancer and estimate the yearly prevalence and incidence of breast cancer between 1997 and 2013. Joinpoint regression analysis was used for the annual percentage change of incidence, prevalence, and survival outcome. Among 12,181,919 female beneficiaries in 2013, the prevalence was 834.37 per 100,000 persons (95% confidence interval, 829.28–839.45) and the incidence was 93.00 per 100,000 person-year (95% confidence interval, 91.27–94.73). The average annual percentage change of the age-standardized breast cancer incidence was 3.5 per 100,000 person-years (3.1–3.8; P < 0.05), suggesting an increase in breast cancer incidence over the study period. The 5-year mortality rate was 4.5% in 1997 and 4.4% in 2008. The 5-year mortality rate among patients with Charlson comorbidity index > 1 was 39.1% (19.2%–59.1%) in 1997 and 21.1% (15.7%-32.0%) in 2008, with an annual percentage change of –0.8 (–1.3 to 2.9), suggesting that the mortality rate was gradually decreasing in patients with comorbidities. In conclusion, 1 in 120 women in Taiwan has breast cancer and the incidence is rising, while the annual percentage change of breast cancer prevalence is decreasing. The mortality rate of breast cancer was essentially stable, but the 1-year, 2-year, and 5-year mortality rates in people with Charlson comorbidity index > 1 were declined.

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“…In Asia, breast cancer incidence is rapidly increasing, and tamoxifen is a principal option of standard adjuvant treatment for ER positive EBC [5,6]. However, the Asian population has been under-represented in international clinical trials on tamoxifen treatment, and thus, the absolute risk of severe complications, such as VTE and uterine cancer, remain uncertain.…”

Section: Introductionmentioning

confidence: 99%

No increased venous thromboembolism risk in Asian breast cancer patients receiving adjuvant tamoxifen

Chen

Lin

et al. 2014

Breast Cancer Res Treat

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Tamoxifen is an effective endocrine treatment for early breast cancer (EBC) but increases the risk of venous thromboembolism. Whether Asian EBC patients (pts) bear the same risk when treated with adjuvant tamoxifen is uncertain. EBC pts diagnosed between 2004 and 2009 were selected from a population database in Taiwan. The pts were followed up from the index date to December 31, 2011 to collect events of deep vein thrombosis (DVT) and pulmonary embolism (PE). Cumulative incidence rates and hazard ratios (HRs) were used to compare the risk between pts treated with and without tamoxifen. In addition, comorbidities were included in an adjusted model of the risk of DVT and PE. A total of 28,029 EBC pts, including 17,843 (63.8 %) in the tamoxifen group and 10,155 (36.2 %) in the nontamoxifen group, were analyzed. The 7-year cumulative incidence rates for DVT and PE were 2.58 and 0.32 % in the tamoxifen group and 2.51 and 0.32 % in the nontamoxifen group (P = 0.92 for DVT, P = 0. 65 for PE), respectively. The HR for the nonadjusted and adjusted models showed no differences in DVT and PE risks between the tamoxifen and nontamoxifen groups. The uterine cancer risk was significantly increased in the pts receiving tamoxifen (adjusted HR = 2.79, P < 0.001), suggesting tamoxifen compliance. The risks of developing DVT and PE are not increased in Asian EBC pts receiving adjuvant tamoxifen. Ethnicity differences should be considered when discussing optimal endocrine treatments with EBC pts.

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Distinct Clinicopathological Features and Prognosis of Emerging Young-Female Breast Cancer in an East Asian Country: A Nationwide Cancer Registry-Based Study

Cited by 50 publications

References 30 publications

Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

Epidemiology and survival outcome of breast cancer in a nationwide study

No increased venous thromboembolism risk in Asian breast cancer patients receiving adjuvant tamoxifen

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