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Copeland J, Oyedeji A, Powell N, Cherian CJ, Tokumaru Y, Murthy V, Takabe K, Young J. Breast Cancer in Jamaica: Stage, Grade and Molecular Subtype Distributions Across Age Blocks, the Implications for Screening and Treatment. World J Oncol 2021; 12:93-103. [PMID: 34349853 PMCID: PMC8297049 DOI: 10.14740/wjon1389] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Breast cancer is the most commonly diagnosed and leading cause of cancer-related morbidity and mortality in females worldwide. Significant disparities exist in breast cancer incidence and mortalities between low- to middle- and high-income countries. The purpose of this study was to analyze the distribution of prognostic and predictive clinicopathological features of invasive breast cancer at a single institution in Jamaica across three age groups. METHODS Data from patients diagnosed with invasive breast cancer who underwent definitive surgery between August 2017 and September 2018 were identified. The patients were divided into three age groups (< 50, 50 - 59 and > 59 years) and the distribution of tumor size, grade, molecular subtype, nodal status and anatomic stage were determined and compared with the US population registry. Comparisons of the various characteristics were performed using the Fisher's exact test. RESULTS Ninety-nine definitive operations were performed and met the criteria for analysis. Average age at the time of diagnosis was 54 years compared to 62 years reported in the US databases. Thirty-six percent of the patients presented below age 50 years, which was twice the corresponding rate reported for Caucasian females (18%) in the USA. Fifty percent of patients in our registry had axillary lymph node metastases at presentation and they were younger than patients with negative axillary nodes (95% confidence interval (CI) -12.06 to -1.93, P = 0.007). Patients in the age group less than age 50 years were more likely to have advanced stage, high histological grade cancers compared to the older age blocks (95% CI 0.039 - 0.902, P = 0.033). CONCLUSION Invasive breast cancer presents at an earlier age in Jamaican women and is associated with poor prognostic features such as high rates of axillary lymph node metastases, high histological grade, advanced stage, triple-negative subtypes and low luminal A subtypes.
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Affiliation(s)
- Jason Copeland
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of General Surgery, Kingston Public Hospital, Kingston, Jamaica, WI
- Department of Surgery, Anesthesia, Radiology and Emergency Medicine, University of West Indies, Mona, Jamaica, WI
| | - Abimbola Oyedeji
- Department of General Surgery, Kingston Public Hospital, Kingston, Jamaica, WI
| | - Neggoshane Powell
- Department of General Surgery, Kingston Public Hospital, Kingston, Jamaica, WI
| | - Cherian J. Cherian
- Department of General Surgery, Kingston Public Hospital, Kingston, Jamaica, WI
- Department of Surgery, Anesthesia, Radiology and Emergency Medicine, University of West Indies, Mona, Jamaica, WI
| | - Yoshihisa Tokumaru
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Vijayashree Murthy
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
| | - Kazuaki Takabe
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
- Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan
- Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14263, USA
- Department of Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
- Department of Breast Surgery and Oncology, Tokyo Medical University, Tokyo 160-8402, Japan
| | - Jessica Young
- Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
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de Lemos LLP, Carvalho de Souza M, Pena Moreira D, Ribeiro Fernandes Almeida PH, Godman B, Verguet S, Guerra AA, Leal Cherchiglia M. Stage at diagnosis and stage-specific survival of breast cancer in Latin America and the Caribbean: A systematic review and meta-analysis. PLoS One 2019; 14:e0224012. [PMID: 31618268 PMCID: PMC6799865 DOI: 10.1371/journal.pone.0224012] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 10/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Female breast cancer is the most common cancer in Latin American and Caribbean (LAC) countries and is the leading cause of cancer deaths. The high mortality-to-incidence ratio in the regions is associated with mainly the high proportion of advanced stage diagnosis, and also to inadequate access to health care. In this study we aimed to systematically review the proportion of advanced stage (III-IV) at diagnosis (pas) and the five-year stage-specific survival estimates of breast cancer in LAC countries. METHODS We searched MEDLINE, Embase, and LILACS (Latin American and Caribbean Health Science Literature) to identify studies, in any language, indexed before Nov 5, 2018. We also conducted manual search by reviewing citations of papers found. pas was summarized by random effects model meta-analysis, and meta-regression analysis to identify sources of variation. Stage-specific survival probabilities were described as provided by study authors, as it was not possible to conduct meta-analysis. PROSPERO CRD42017052493. RESULTS For pas we included 63 studies, 13 of which population-based, from 22 countries comprising 221,255 women diagnosed from 1966 to 2017. The distribution of patients by stage varied greatly in LAC (pas 40.8%, 95%CI 37.0% to 44.6%; I2 = 99%; p<0.0001). The heterogeneity was not explained by any variable included in the meta-regression. There was no difference in pas among the Caribbean (pas 43.0%, 95%CI 33.1% to 53.6%), Central America (pas 47.0%, 95%CI 40.4% to 53.8%) and South America (pas 37.7%, 95%CI 33.1% to 42.5%) regions. For 5-year stage-specific survival we included 37 studies, comprising 28,988 women from ten countries. Seven of these studies were included also for pas. Since we were unable to adjust for age, comparability between countries and regions was hampered, and as expected, the results varied widely from study to study. CONCLUSIONS LAC countries should look to address concerns with early detection and diagnosis of breast cancer, and wherever viable implement screening programs and to provide timely treatment.
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Affiliation(s)
- Lívia Lovato Pires de Lemos
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Mirian Carvalho de Souza
- Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniela Pena Moreira
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Henrique Ribeiro Fernandes Almeida
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, Scotland
- Division of Clinical Pharmacology, Karolinska University Hospital Huddinge, Karolinska Institutet, Huddinge, Sweden
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Augusto Afonso Guerra
- SUS Collaborating Centre for Technology Assessment and Excellence in Health, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Mariangela Leal Cherchiglia
- Programa de Pós-Graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ragin C, Banydeen R, Zhang C, Ben A, Calabrese V, Villa NN, Reville J, Dasgupta S, Bandyopadhyay M, Louden D, Dasgupta S. Breast Cancer Research in the Caribbean: Analysis of Reports From 1975 to 2017. J Glob Oncol 2018; 4:1-21. [PMID: 30481085 PMCID: PMC6818300 DOI: 10.1200/jgo.18.00044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Breast cancer is among the leading causes of death resulting from cancer in Caribbean women. Studies examining exogenous and genetically predetermined endogenous risk factors are critical to define breast cancer susceptibility in Caribbean women. The purpose of this systematic review is to assess the existing scientific literature in the last 42 years (1975 to 2017) to describe the body of research generated for the population of this region and determine future research directions. METHODS We selected published research articles using a combination of definite keyword searches in PubMed. Only articles presenting the Caribbean population as the focus of their research objectives were included in this analysis. RESULTS Studies on breast cancer in the Caribbean are limited. A majority of publications on Caribbean populations were descriptive, focusing on cancer trends and clinicopathologic factors. High incidence and mortality rates for breast cancer are reported for the region, and there seem to be some differences between countries in the frequency of cases according to age at presentation. A limited number of epidemiologic, behavioral, and genetic and molecular studies were conducted in more recent years. CONCLUSION A regional strategy for cancer registration is needed for the Caribbean to address possible underestimates of breast cancer incidence. Furthermore, behavioral, molecular, genetic, and epidemiologic investigations of breast cancer are critical to address the concerns related to currently described high incidence and mortality rates in the Caribbean.
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Affiliation(s)
- Camille Ragin
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Rishika Banydeen
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Christine Zhang
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Athena Ben
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Victoria Calabrese
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Nina N. Villa
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Jade Reville
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Shaoni Dasgupta
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Mausumi Bandyopadhyay
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Delroy Louden
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
| | - Subhajit Dasgupta
- Camille Ragin, Fox Chase Cancer Center, Temple Health;
Camille Ragin, African Caribbean Cancer Consortium,
Philadelphia, PA; Rishika Banydeen, Centre Hospitalier
Universitaire de Martinique; Rishika Banydeen, African Caribbean
Cancer Consortium, Fort-de-France, Martinique; Christine Zhang,
Athena Ben, Victoria Calabrese, Nina N.
Villa, Jade Reville, and Subhajit Dasgupta,
Saint James School of Medicine; Subhajit Dasgupta, African
Caribbean Cancer Consortium, The Quarter; Delroy Louden, Anguilla
Community College, George Hill, Anguilla; Shaoni Dasgupta, Academic
Magnet High School; and Mausumi Bandyopadhyay, Trident Technical
College, Charleston, SC
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