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Hermansyah D, Firsty NN, Siagian RHN, Dwinda NN. Intercontinental Comparison of Immunohistochemical Subtypes Among Individuals With Breast Cancer in South-East Asia and South America: A Scoping Systematic Review and Meta-Analysis of Observational Studies. World J Oncol 2024; 15:355-371. [PMID: 38751698 PMCID: PMC11092420 DOI: 10.14740/wjon1788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background Breast cancer (BC) remains a significant global concern, particularly among developing countries in South-East Asia (SEA) and South America (SA). The socioeconomic burdens of oncologic care in those countries were often originated from limited accessibility on attainable therapeutic options and reliability on identifying essential information of cancer cells, i.e., immunohistochemical (IHC) subtyping to determine suitable approaches. The triple-negative breast cancer (TNBC) is among the most aggressive category in breast malignancy, therefore, requiring more specific molecular pathway blocking to exhaust the cells. However, large-scale epidemiological investigation on its rate among BC remains unavailable to date. This study aimed to describe the prevalence of TNBC in the SEA and SA continents since it may guide the future direction of oncologic research and trials. Methods This review focuses on observational studies from the SEA and SA continents from the last decade. Each study represents its country or cities, period of observation, population size, and the TNBC-BC rate as the main outcomes. Therefore, we may also limit the reporting bias originated from same-patient data on the specific occasions. The analysis will be derived to SEA-SA comparison, plus SEA/SA-specific session as processed in Comprehensive Meta-Analysis (CMA) version 3.0. The statistical analysis will be performed in random effects model (REM) within 95% confidence interval (CI). Results From 46 studies included in the final analysis with a total enlisted population of 34,346 unique individuals with BC, the TNBC rate was higher in the SEA compared to the SA region (19.3% vs. 15.7%; P < 0.05 in 95% CI), with the highest prevalence observed in Vietnam (22.4%) and Peru (17.8%), if it was restricted on countries with two or more studies. Interestingly, both Laos and Argentina possessed significant differences compared to other countries within their respective continents, with the highest and lowest TNBC rates (P < 0.05). Conclusions The IHC characteristics in SEA differ from those in the SA continent as mainly represented by TNBC prevalence, possibly shaping the course of future trials in the respective region based on IHC expressivity status.
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Affiliation(s)
- Dedy Hermansyah
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Naufal Nandita Firsty
- Graduate Program in Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Putri Hijau Level II Military Hospital, Medan, Indonesia
| | - Ruth Hasian Nami Siagian
- Graduate Program in Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Datu Sanggul Rantau Public Hospital, Tapin, Indonesia
| | - Najwa Nandita Dwinda
- Undergraduate Program in Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Quang DT, Luong Thi T, Nguyen Di K, Vu Thi Quynh C, Nguyen Thi Hoa H, Phan Ngoc Q. Illuminating the breast cancer survival rates among Southeast Asian women: A systematic review and meta-analysis spanning four decades. Curr Probl Cancer 2024; 48:101062. [PMID: 38309146 DOI: 10.1016/j.currproblcancer.2024.101062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 02/05/2024]
Abstract
In Southeast Asia, breast cancer is the most prevalent cancer among women and ranks as the second leading cause of cancer-related deaths. This systematic review and meta-analysis, encompassing 27 observational cohort studies with a minimum one-year follow-up period, aimed to examine temporal trends in breast cancer survival rates. Among the subset of five out of eleven Southeast Asian nations with available data, our analysis revealed pooled survival rates of 88.8 % at 1 year, 73.8 % at 3 years, 70.8 % at 5 years, and 49.3 % at 10 years for breast cancer patients. The mean age at diagnosis was 50.77±10.07 years, with 52.81 % of patients presenting with positive lymph nodes. Notably, stages I and II remained predominant even five years post-diagnosis. Although an overall amelioration in survival rates transpired over the preceding four decades, a noticeable exception pertained to the 3-year rate, demonstrating limited improvement. These findings underscore the pressing need for enhanced research efforts, particularly in countries within the region that lack survival data, to enable accurate estimations. Furthermore, our review also emphasizes the crucial need for future comprehensive, well-designed studies to delve into the factors behind survival rate disparities in Southeast Asia and the younger age at diagnosis compared to other regions.
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Affiliation(s)
- Duc Tran Quang
- Faculty of Health Sciences, Dong Nai Technology University, Nguyen Khuyen Street, Trang Dai Ward, Bien Hoa City, Vietnam.
| | - Thanh Luong Thi
- Faculty of Health Sciences, Dong Nai Technology University, Nguyen Khuyen Street, Trang Dai Ward, Bien Hoa City, Vietnam
| | - Khanh Nguyen Di
- Faculty of Health Sciences, Dong Nai Technology University, Nguyen Khuyen Street, Trang Dai Ward, Bien Hoa City, Vietnam
| | - Chi Vu Thi Quynh
- The University of Danang, School of Medicine and Pharmacy, 41 Le Duan, Hai Chau, Danang 550000, Vietnam
| | - Huyen Nguyen Thi Hoa
- College of Health Sciences, VinUniveristy, Vinhomes Ocean Park, Gia Lam District, Hanoi, Vietnam
| | - Quang Phan Ngoc
- The Center Service For Technology Science Of Medi-Phar. Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street Thai Binh city, Vietnam
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Peres SV, Arantes PE, Fagundes MDA, Ab'Saber AM, Gimenes DL, Curado MP, Vieira RADC. Molecular subtypes as a prognostic breast cancer factor in women users of the São Paulo public health system, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230028. [PMID: 37255208 DOI: 10.1590/1980-549720230028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 03/29/2023] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the prognosis of women with breast cancer by molecular subtypes, sociodemographic variables, and clinical and treatment characteristics. METHODS This hospital-based retrospective cohort study analyzed 1,654 women over 18 years of age diagnosed with invasive breast cancer from 2000 to 2018. Data were extracted from Brazil's Oncocenter Foundation of São Paulo. The variables analyzed were age, histology, molecular subtypes, clinical staging, treatment type, and diagnosis-to-treatment time. Cox regression analysis was applied to estimate death risk. RESULTS Women with HER-2-positive (nonluminal) and triple-negative molecular subtypes were more than twice more likely to be at risk of death, with adjusted hazard ratio - HRadj=2.30 (95% confidence interval - 95%CI 1.34-3.94) and HRadj=2.51 (95%CI 1.61-3.92), respectively. A delayed treatment associated with an advanced clinical stage at diagnosis increased fourfold the risk of death (HRadj=4.20 (95%CI 2.36-7.49). CONCLUSION In summary, besides that interaction between advanced clinical stage and longer time between diagnosis and treatment, HER-2-positive (nonluminal) and triple-negative phenotypes were associated with a worse prognosis. Therefore, actions to reduce barriers in diagnosis and treatment can provide better outcome, even in aggressive phenotypes.
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Affiliation(s)
- Stela Verzinhasse Peres
- Fundação Oncocentro de São Paulo, Department of Information and Epidemiology - São Paulo (SP), Brazil
| | - Paola Engelmann Arantes
- A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil
| | - Marcela de Araújo Fagundes
- A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil
| | - Alexandre Muxfeldt Ab'Saber
- Fundação Oncocentro de São Paulo, Department of Pathology - São Paulo (SP), Brazil
- Universidade de São Paulo, Clinical Hospital - São Paulo (SP), Brazil
| | - Daniel Luiz Gimenes
- Grupo Oncoclínicas de São Paulo, Department of Mastology - São Paulo (SP), Brazil
| | - Maria Paula Curado
- A.C. Camargo Cancer Center, Centro International de Pesquisa, Cancer Epidemiology and Statistics Group - São Paulo (SP), Brazil
| | - René Aloisio da Costa Vieira
- Universidade de São Paulo, Faculty of Medicine of Botucatu, Graduate Program in Obstetrics and Gynecology - Botucatu (SP), Brazil
- Hospital do Câncer de Barretos, Graduate Program in Oncology - Barretos (SP), Brazil
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Intrieri T, Manneschi G, Caldarella A. 10-year survival in female breast cancer patients according to ER, PR and HER2 expression: a cancer registry population-based analysis. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04245-1. [PMID: 36129548 DOI: 10.1007/s00432-022-04245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/01/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Invasive breast cancer prognosis has significantly improved over time; however, there are few data about the long-term survival. MATERIALS AND METHODS We analysed the data on female breast cancer incident during 2004-2005 in the area of the Tuscan Cancer Registry, distinguishing them in five subtypes, according to ER, PgR, HER2, and Ki67 expression: luminal A, luminal B, luminal B/HER2 + , triple-negative, and HER2 + . Effects of subtypes and age on 10 years breast cancer specific survival were analysed by Kaplan-Meier and multivariate Cox analysis. RESULTS The majority of breast cancer were luminal B (57%), and 45% of them were diagnosed at pathological stage I. The 10-year survival rates (p < 0.001) were higher among luminal A (90.2%) and lower among HER-2 + patients (70.3%). Prognostic effect of age was statistically significant (p < 0.0004): the 10-year cancer specific survival rates were higher among 40-59 years of age patients (88.5%), lower among 0-39 (75.8%). Luminal A breast cancer patients had a constant low risk throughout 10 years of follow up, while luminal B/HER2 + and triple negative tumours showed a peak 5 years after the diagnosis and then declined. DISCUSSION Our study confirmed the prognostic effect of biological subtype also in a long term follow up study; moreover, age at diagnosis showed to influence the outcome, other than stage at diagnosis and treatment. The long term follow up showed a constant risk of death for luminal A and B tumours, whereas for non-luminal cancer a peak 5 years after the diagnosis was found.
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Affiliation(s)
- Teresa Intrieri
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy
| | - Gianfranco Manneschi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy
| | - Adele Caldarella
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Villa delle Rose Via Cosimo il Vecchio, 2- 50139, Florence, Italy.
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Rothschild HT, Abel MK, Patterson A, Goodman K, Shui A, van Baelen K, Desmedt C, Benz C, Mukhtar RA. Obesity and menopausal status impact the features and molecular phenotype of invasive lobular breast cancer. Breast Cancer Res Treat 2021; 191:451-458. [PMID: 34817747 PMCID: PMC8763723 DOI: 10.1007/s10549-021-06453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/14/2021] [Indexed: 11/09/2022]
Abstract
Purpose We investigated the relationship between obesity, menopausal status, and invasive lobular carcinoma (ILC), the second most common histological subtype of breast cancer. Specifically, we evaluated the association between body mass index (BMI), metabolic syndrome, the 21-gene Oncotype Recurrence Score (Oncotype RS), and pathological features in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor-2-negative ILC. Methods The study cohort included 491 patients from a prospectively maintained institutional database consisting of patients with stage I-III, HR-positive ILC who underwent surgical treatment between 1996 and 2019. Results Contrary to our expectations, we found that lower BMI was significantly associated with having higher Oncotype RS (18.9% versus 4.8%, p = 0.028) in post-menopausal patients, but was not related to tumor characteristics in pre-menopausal patients. Multivariate network analyses suggested a strong relationship between post-menopausal status itself and tumor characteristics, with lesser influence of BMI. Conclusion These findings provide further insight into the recently appreciated heterogeneity within ILC and support the need for further investigation into the drivers of this disease and tailored treatment strategies.
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Affiliation(s)
| | - Mary Kathryn Abel
- School of Medicine, University of California, San Francisco, CA, 94143, USA
| | - Anne Patterson
- Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, 94143, USA
| | - Kent Goodman
- Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, 94143, USA
| | - Amy Shui
- Department of Surgery Biostatistics Core, University of California, San Francisco, CA, 94143, USA
| | - Karen van Baelen
- Department of Oncology, Laboratory for Translational Breast Cancer Research, KU Leuven, B-3000, Leuven, Belgium
| | - Christine Desmedt
- Department of Oncology, Laboratory for Translational Breast Cancer Research, KU Leuven, B-3000, Leuven, Belgium
| | | | - Rita A Mukhtar
- Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, CA, 94143, USA
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Kanbayti IH, Rae WID, McEntee MF, Gandomkar Z, Ekpo EU. Clinicopathologic breast cancer characteristics: predictions using global textural features of the ipsilateral breast mammogram. Radiol Phys Technol 2021; 14:248-261. [PMID: 34076829 DOI: 10.1007/s12194-021-00622-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/25/2021] [Accepted: 05/28/2021] [Indexed: 11/25/2022]
Abstract
Radiomic features from mammograms have been shown to predict breast cancer (BC) risk; however, their contribution to BC characteristics has not yet been explored. This study included 184 women with BC between January 2012 and April 2017. A set of 33 global radiomic features were extracted from the ipsilateral breast mammogram. Associations between radiomic features and BC characteristics were investigated by univariate logistic regression analysis, and receiver-operating characteristic curve analysis was employed to evaluate the predictive performance of radiomic features. Histogram-based features (mean, 70th percentile, and 30th percentile) weakly differentiated progesterone status and tumor size (AUC range: 0.627-0.652, p ≤ 0.007). One gray level run length matrix (GLRLM)-based feature achieved an AUC of 0.68 in discriminating lymph-node status, and the fractal dimension achieved an AUC of 0.65 in predicting tumor size. After stratifying by age at BC diagnosis and baseline percent density (PD), the average predictive performance of the abovementioned features improved from 0.652 to 0.707 for baseline PD adjustment, and from 0.652 to 0.674 for age at BC diagnosis. Higher predictive performances were found for GLRLM-based features in predicting lymph-node status among younger women with high baseline PD (AUC range: 0.710-0.863), and for fractal features in predicting tumor size among patients with low PD (AUC: 0.704). Global radiomic features from the ipsilateral breast mammogram can predict lymph-node status and tumor size among certain categories of women and should be considered as a non-invasive tool for clinical decision-making in BC-affected women and for forecasting disease progression.
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Affiliation(s)
- Ibrahem H Kanbayti
- Diagnostic Radiography Technology Department, Faculty of Applied Medical Sciences, King Abdul-Aziz University, Jeddah, Saudi Arabia.
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia.
| | - William I D Rae
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
| | - Mark F McEntee
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
- Department of Medicine Roinn Na Sláinte, Brookfield Health Sciences, UG 12 Áras Watson, Galway, T12 AK54, Ireland
| | - Ziba Gandomkar
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
| | - Ernest U Ekpo
- Medical Image Optimization and Perception Group (MIOPeG), Faculty of Medicine and Health, The University of Sydney, Campus C4 75 East Street, Sydney, NSW 2141, Australia
- Orange Radiology, Laboratories and Research Centre, Calabar, Nigeria
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Individualized Prediction of Breast Cancer Survival Using Flexible Parametric Survival Modeling: Analysis of a Hospital-Based National Clinical Cancer Registry. Cancers (Basel) 2021; 13:cancers13071567. [PMID: 33805407 PMCID: PMC8037061 DOI: 10.3390/cancers13071567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/18/2022] Open
Abstract
Simple Summary Prognostication of breast cancer patients is essential for risk communication and clinical decision-making. Many clinical tools for the survival prediction of breast cancer patients have been developed over the years. However, most of them were developed from Western countries. Studies have shown that these tools did not perform well in other ethnicities, such as Asian populations, including Thai. This study developed a new prediction model for survival predictions using modern statistical methods that allow a more accurate estimation of the baseline survival. The model was entitled the Individualized Prediction of Breast cancer Survival or the IPBS model. It contains twelve routinely available predictors that oncologists usually evaluate in daily practice. The survival information provided by the model was proven to be acceptably accurate and might be useful for physicians and patients, especially in Thailand or other Asian countries, to arrive at the most appropriate management plan. Abstract Prognostic models for breast cancer developed from Western countries performed less accurately in the Asian population. We aimed to develop a survival prediction model for overall survival (OS) and disease-free survival (DFS) for Thai patients with breast cancer. We conducted a prognostic model research using a multicenter hospital-based cancer clinical registry from the Network of National Cancer Institutes of Thailand. All women diagnosed with breast cancer who underwent surgery between 1 January 2010 and 31 December 2011 were included in the analysis. A flexible parametric survival model was used for developing the prognostic model for OS and DFS prediction. During the study period, 2021 patients were included. Of these, 1386 patients with 590 events were available for a complete-case analysis. The newly derived individualized prediction of breast cancer survival or the IPBS model consists of twelve routinely available predictors. The C-statistics from the OS and the DFS model were 0.72 and 0.70, respectively. The model showed good calibration for the prediction of five-year OS and DFS. The IPBS model provides good performance for the prediction of OS and PFS for breast cancer patients. A further external validation study is required before clinical implementation.
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Jonnada PK, Sushma C, Karyampudi M, Dharanikota A. Prevalence of Molecular Subtypes of Breast Cancer in India: a Systematic Review and Meta-analysis. Indian J Surg Oncol 2020; 12:152-163. [PMID: 33994741 DOI: 10.1007/s13193-020-01253-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/15/2020] [Indexed: 12/24/2022] Open
Abstract
In the last two decades, India has witnessed a substantial increase in the incidence of breast cancer and associated mortality. Studies on the prevalence of molecular subtypes of breast cancer in India have reported inconsistent results. Therefore, we conducted a systematic review of observational studies to document the prevalence of molecular subtypes of breast cancer. A complete literature search for observational studies was conducted in MEDLINE and EMBASE databases using key MeSH terms ((molecular classification) OR (molecular subtypes)) AND (breast cancer)) OR (breast carcinoma)) AND (prevalence)) AND (India). Two reviewers independently reviewed the retrieved studies. The screened studies satisfying the eligibility were included. The quality of included studies was assessed using the selected STROBE criteria. The overall pooled prevalence of luminal A, luminal B, HER2-enriched, and triple-negative breast cancer (TNBC) subtypes of breast cancer were 0.33 (95% CI 0.23-0.44), 0.17 (95% CI 0.12-0.23), 0.15 (95% CI 0.12-0.19), and 0.30 (95% CI 0.27-0.33), respectively. Subgroup analyses were performed by mean age of patients, time period, region, and sample size of the study. Among molecular subtypes of breast cancer, luminal A was the most prevalent subtype followed by TNBC, luminal B, and HER2-enriched subtypes. The overall prevalence of TNBC in India is high compared to other regions of the world. Additional research is warranted to identify the determinants of high TNBC in India. Differentiating TNBC from other molecular subtypes is important to guide therapeutic management of breast cancer.
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Affiliation(s)
- Pavan Kumar Jonnada
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Dr. M H Marigowda road, Bangalore, Karnataka 560029 India
| | - Cherukuru Sushma
- Department of Pathology, AmPath Laboratory Pvt. Limited, Citizens Hospital, Hyderabad, India
| | - Madhuri Karyampudi
- Department of Radiation Oncology, MNJ Institute of Oncology, Hyderabad, India
| | - Anvesh Dharanikota
- Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Dr. M H Marigowda road, Bangalore, Karnataka 560029 India
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Pandit P, Patil R, Palwe V, Gandhe S, Patil R, Nagarkar R. Prevalence of Molecular Subtypes of Breast Cancer: A Single Institutional Experience of 2062 Patients. Eur J Breast Health 2019; 16:39-43. [PMID: 31912012 DOI: 10.5152/ejbh.2019.4997] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/02/2019] [Indexed: 01/19/2023]
Abstract
Objective The aim of the study was to analyze the prevalence of molecular subtypes of all breast cancer patients treated at tertiary cancer centre in West India in 12 years. Materials and Methods A retrospective observational study carried out in Tertiary Cancer Care Centre in Western India. Electronic medical records of all breast cancer patients were retrieved from the hospital database between March 2007 to March 2019. Patient's characteristic, histological features and molecular subtypes were collected and analyzed. Results A total of 2062 women fulfilled the criteria for this study and were analyzed. The median age of study population was 51 years (range 22-100 years). Among these, 1357 (65.8%) were of ≤55 years and 705 (34.2%) were over 55 years. The overall incidence of Hormonal Receptor-positive patients (either estrogen-receptor (ER) or progesterone-receptor (PR) or both) was 1162 (56.4%). The Mean tumor size was 3.8cm (range 0-18cm). The most common histology was IDC (96%). Axillary nodes were positive in 62.5%. Luminal type A was positive in 762 (37%) patients while Luminal type B was present in 157 (7.6%) patients. Basal-like subtype was observed in 537 (26%) patients while HER2 rich subtype was seen in 229 (11.1%). The incidence of Luminal A subtype increased with age. The highest observed among patients (72%) aged 70 years or more. Incidence of Basal like subtype was highest in patients less than 30 years (52%). Conclusion Luminal-like disease is the most common molecular subtype in India. Identification of Basal like breast cancer, a highly aggressive, biologically and clinically distinct subtype different than its non-basal variant, is important for treatment planning and target therapy.
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Affiliation(s)
- Prakash Pandit
- Department of Radiation Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
| | - Roshankumar Patil
- Department of Radiation Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
| | - Vijay Palwe
- Department of Radiation Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
| | - Sucheta Gandhe
- Department of Pathology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
| | - Rahul Patil
- Department of Pathology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
| | - Rajnish Nagarkar
- Department of Surgical Oncology, HCG Manavata Cancer Centre, Nashik, Maharashtra, India
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Breast Cancer in Young Women: Status Quo and Advanced Disease Management by a Predictive, Preventive, and Personalized Approach. Cancers (Basel) 2019; 11:cancers11111791. [PMID: 31739537 PMCID: PMC6896106 DOI: 10.3390/cancers11111791] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/24/2022] Open
Abstract
Why does healthcare of breast cancer (BC) patients, especially in a young population, matter and why are innovative strategies by predictive, preventive, and personalized medicine (PPPM) strongly recommended to replace current reactive medical approach in BC management? Permanent increase in annual numbers of new BC cases with particularly quick growth of premenopausal BC patients, an absence of clearly described risk factors for those patients, as well as established screening tools and programs represent important reasons to focus on BC in young women. Moreover, "young" BC cases are frequently "asymptomatic", difficult to diagnose, and to treat effectively on time. The objective of this article is to update the knowledge on BC in young females, its unique molecular signature, newest concepts in diagnostics and therapy, and to highlight the concepts of predictive, preventive, and personalized medicine with a well-acknowledged potential to advance the overall disease management.
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