Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Trends in Epidemiology, Clinical and Histopathological Characteristics of Breast Cancer in Iran: Results of a 17 Year Study

  • Afsharfard, Aboulfazl (Department of Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences) ;
  • Mozaffar, Mohammad (Department of Surgery, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences) ;
  • Orang, Elahe (Islamic Azad University, Tehran Medical Branch) ;
  • Tahmasbpour, Eisa (Young Research Club, Islamic Azad University)
  • Published : 2013.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Breast cancer (BC) is the top cancer among women worldwide and the most frequent malignancy among Iranian women over the past few decades. The increasing trend and high mortality rate of BC in the developing world necessitates studies concentrating on its characteristics in countries in Asia. The current study focused on clinical and histopathological features of BC among Iranian females. Materials and Methods: This retrospective study involved 714 Iranian patients with histopathologically proven BC undergoing resection of primary tumours and axillary clearance. Demographic, clinical and histopathological data were obtained and studied between ten year age groups (${\leq}40$ years, 41-50 years, 51-60 years, 61-70 years, and ${\leq}71$ years) in four chronologic phases from 1994-2009. Results: Mean age of patients was $49.4{\pm}13.1$ years. Most of cases (33.2%) were in 41-50 group. Mean size of primary tumors was $3.94{\pm}2.47$ cm and 87.1% of cases had infiltrative ductal carcinoma. Modified radical mastectomy was the most common method of surgery carried out (48.8%). Some 57.1% of tumors were in pT2 and tumor size decreased significantly during the period (p<0.05). The most common BC stage was llla (27%). Lower BC stages (0 and 1) constituted 13.9% of the diagnosed tumors. Our series of patients aged ${\leq}40$ had larger tumors (mean $4.73{\pm}3.02$ cm) compared to older age groups (p=0.003). Lower stages (0 and I) were more frequent among the oldest patients while nearly 50% of patients aged ${\leq}40$ had tumor stage III. We also observed a significant decreasing trend in the mean LN count (p<0.05) and blood vessel invasion (p=0.023) from younger to older age groups. Conclusions: More aggressive disease for younger age groups, earlier peak incidence age and high rate of advanced BC at the time of diagnosis among Iranian women, were the main findings of this study.

Keywords

References

  1. Agarwal G, Pradeep PV, Aggarwal V, et al (2007). Spectrum of breast cancer in Asian women. World J Surg, 31, 1031-40. https://doi.org/10.1007/s00268-005-0585-9
  2. Benz CC (2008). Impact of aging on the biology of breast cancer. Crit Rev Oncol Hematol, 66, 65-74. https://doi.org/10.1016/j.critrevonc.2007.09.001
  3. Botteri E, Bagnardi V, Goldhirsch A, et al (2010). Axillary lymph node involvement in women with breast cancer: does it depend on age? Clin Breast Cancer, 10, 318-21. https://doi.org/10.3816/CBC.2010.n.042
  4. Colleoni M, Rotmensz N, Robertson C, et al (2002). Very young women (<35 years) with operable breast cancer: features of disease at presentation. Ann Oncol, 13, 273-9.
  5. Fisher CJ, Egan MK, Smith P, et al (1997). Histopathology of breast cancer in relation to age. Br J Cancer, 75, 593-6. https://doi.org/10.1038/bjc.1997.103
  6. Fleming ID, Cooper JS, Henson DE, et al (1997). American Joint Committee on Cancer: AJCC Cancer Staging Manual, 5th edition. Philadelphia, PA: Lippincott- Raven.
  7. Foxcroft LM, Evans EB, Porter AJ (2004). The diagnosis of breast cancer in women younger than 40. Breast, 13, 2-306.
  8. Gennari R, Curigliano G, Rotmensz N, et al (2004). Breast carcinoma in elderly women: features of disease presentation, choice of local and systemic treatments compared with younger postmenopasual patients. Cancer, 101, 1302-10. https://doi.org/10.1002/cncr.20535
  9. Harirchi I, Ebrahimi M, Zamani N, et al (2000). Breast cancer in Iran: a review of 903 case records. Public Health, 114, 143-5.
  10. Harirchi I, Karbakhsh M, Kashefi A, et al (2004). Breast cancer in Iran: results of a multi-center study. Asian Pac J Cancer Prev, 5, 24-7.
  11. Harirchi I, Karbakhsh M, Montazeri A, et al (2010). Decreasing trend of tumor size and downstaging in breast cancer in Iran: results of a 15-year study. Eur J Cancer Prev, 19, 126-30. https://doi.org/10.1097/CEJ.0b013e328333d0b3
  12. Harirchi I, Kolahdoozan S, Karbakhsh M, et al (2011). Twenty years of breast cancer in Iran: downstaging without a formal screening program. Ann Oncol, 22, 93-7. https://doi.org/10.1093/annonc/mdq303
  13. Karihtala P, Winqvist R, Bloigu R, et al (2010). Long-term observational follow-up study of breast cancer diagnosed in women ${\leq}$40 years old. Breast, 19, 456-61. https://doi.org/10.1016/j.breast.2010.05.001
  14. Medical Advisory Secretariat (2007). Screening Mammography for women aged 40 to 49 Years at average risk for breast cancer: an evidence-based analysis. Ontario Health Technology Assessment Series ,7, 1-29.
  15. Mohammad K, Sadat Hashemi SM, Farahani FK (2004). Age at natural menopause in Iran. Maturitas, 49, 321-6. https://doi.org/10.1016/j.maturitas.2004.02.006
  16. Molino A, Giovannini M, Auriemma A, et al (2006). Pathological, biological and clinical characteristics, and surgical management, of elderly women with breast cancer. Crit Rev Oncol Hematol, 59, 226-33. https://doi.org/10.1016/j.critrevonc.2006.01.007
  17. Mousavi SM, Montazeri A, Mohagheghi MA, et al (2007). Breast cancer in Iran: an epidemiological review. Breast J, 13, 383-91. https://doi.org/10.1111/j.1524-4741.2007.00446.x
  18. Mousavi SM, Harirchi I, Ebrahimi M, et al (2008). Screening for breast cancer in Iran: a challenge for health policy makers. Breast J, 14, 605-6. https://doi.org/10.1111/j.1524-4741.2008.00662.x
  19. Mousavi SM, Gouya MM, Ramazani R, et al (2009). Cancer incidence and mortality in Iran. Ann Oncol, 20, 556-63.
  20. Orang E, Tahmasbpour E, Afsharfard A (2013). Predictive role of tumor size in breast cancer with axillary lymph node involvement - can size of primary tumor be used to omit an unnecessary axillary lymph node dissection? Asian Pac J Cancer Prev, 14, 717-22. https://doi.org/10.7314/APJCP.2013.14.2.717
  21. Parkin DM, Bray F, Ferley J, et al (2001). Estimating the world cancer burden: Globocan 2000. Int J Cancer, 94, 153-6. https://doi.org/10.1002/ijc.1440
  22. Parkin DM, Fernandez LM (2006). Use of statistics to assess the global burden of breast cancer. Breast J, 12, 70-80. https://doi.org/10.1111/j.1075-122X.2006.00205.x
  23. Porter PL (2009). Global trends in breast cancer incidence and mortality. Salud Publica Mex, 51, 141-6. https://doi.org/10.1590/S0036-36342009000800003
  24. Sharma K, Costas A, Shulman LN, et al (2012). A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. J Oncol, 121873.
  25. Shibuya K, Mathers CD, Boschi-Pinto C, et al (2002). Global and regional estimates of cancer mortality and incidence by site: II. Results for the global burden of disease 2000. BMC Cancer, 2, 37. https://doi.org/10.1186/1471-2407-2-37
  26. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  27. Smigal C, Jemal A, Ward E, et al (2006). Trends in breast cancer by race and ethnicity: update 2006. CA Cancer J Clin, 56, 168-83. https://doi.org/10.3322/canjclin.56.3.168
  28. Winchester DP, Osteen RT, Menck HR (1996). The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer, 78, 1838-43. https://doi.org/10.1002/(SICI)1097-0142(19961015)78:8<1838::AID-CNCR27>3.0.CO;2-Y
  29. Yancik R, Wesley MN, Ries LA, et al (2001). Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA, 285, 885-92. https://doi.org/10.1001/jama.285.7.885

Cited by

  1. Lack of Prognostic Value of Blood Parameters in Patients Receiving Adjuvant Radiotherapy for Breast Cancer vol.15, pp.10, 2014, https://doi.org/10.7314/APJCP.2014.15.10.4225
  2. Five Year Survival of Women with Breast Cancer in Yazd vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6597
  3. Clinicopathologic Features Predicting Involvement of Nonsentinel Axillary Lymph Nodes in Iranian Women with Breast Cancer vol.15, pp.17, 2014, https://doi.org/10.7314/APJCP.2014.15.17.7049
  4. Trends in Incidence of Breast Cancer among Women under 40 in Asia vol.15, pp.3, 2014, https://doi.org/10.7314/APJCP.2014.15.3.1387
  5. A Clinical Database of Breast Cancer Patients Reveals Distinctive Clinico-pathological Characteristics: a Study From Central China vol.15, pp.4, 2014, https://doi.org/10.7314/APJCP.2014.15.4.1621
  6. Chemotherapy-Induced Cardiomyopathy in Breast Cancer Patients vol.3, pp.3, 2014, https://doi.org/10.5812/cardiovascmed.19096
  7. Description of Deaths on Easter Island, 2000-2012 Period vol.15, pp.23, 2014, https://doi.org/10.7314/APJCP.2014.15.23.10091
  8. Demographic Survey of Four Thousand Patients with 10 Common Cancers in North Eastern Iran over the Past Three Decades vol.15, pp.23, 2014, https://doi.org/10.7314/APJCP.2014.15.23.10193
  9. Prognostic Factors for Survival in Patients with Breast Cancer Referred to Omitted Cancer Research Center in Iran vol.16, pp.12, 2015, https://doi.org/10.7314/APJCP.2015.16.12.5081
  10. Trends and Analysis of Cancer Incidence for Common Male and Female Cancers in the Population of Punjab Province of Pakistan during 1984 to 2014 vol.16, pp.13, 2015, https://doi.org/10.7314/APJCP.2015.16.13.5297
  11. Preparation of Immunotoxin Herceptin-Botulinum and Killing Effects on Two Breast Cancer Cell Lines vol.16, pp.14, 2015, https://doi.org/10.7314/APJCP.2015.16.14.5977
  12. Spatial and Temporal Epidemiological Assessment of Breast Cancer Incidence and Mortality in Kazakhstan, 1999-2013 vol.16, pp.15, 2015, https://doi.org/10.7314/APJCP.2015.16.15.6795
  13. Religious Coping and Quality of Life in Women with Breast Cancer vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7721
  14. Health Beliefs of Nursing Faculty Students about Breast Cancer and Self Breast Examination vol.16, pp.17, 2015, https://doi.org/10.7314/APJCP.2015.16.17.7731
  15. Epidemiology and Trend of Cancers in the Province of Kerman: Southeast of Iran vol.16, pp.4, 2015, https://doi.org/10.7314/APJCP.2015.16.4.1409
  16. Analysis of Cancer Incidence and Mortality in Iran Using Joinpoint Regression Analysis vol.19, pp.3, 2016, https://doi.org/10.5812/ircmj.42071
  17. The Rise in Mortality from Breast Cancer in Young Women: Trend Analysis in Brazil vol.12, pp.1, 2017, https://doi.org/10.1371/journal.pone.0168950
  18. Breast cancer in elderly women and altered clinico-pathological characteristics: a systematic review pp.1573-7217, 2017, https://doi.org/10.1007/s10549-017-4448-5
  19. The Shiraz Breast Cancer Registry (SBCR): study design and primary reports pp.1744-828X, 2018, https://doi.org/10.2217/pme-2018-0047