Addressing the Younger Age at Onset in Breast Cancer Patients in Asia: An Age-Period-Cohort Analysis of Fifty Years of Quality Data from the International Agency for Research on Cancer

Introduction. There is an established fact that Asian breast cancer patients are, on average, younger than their European counterparts. This study aimed to utilize the data from the Cancer Incidence in Five Continents I through XIII (published by the International Agency for Research on Cancer) to examine what contributes to the younger age at onset in the Asian population. Material and Methods. Data (number of breast cancer cases and corresponding population figures) for 29 registries in Europe and 9 registries in Asia for the period of 1953–2002 was accessioned and pooled to form two distinct populations, Asia and Europe. The age specific rates were defined and analyzed cross-sectionally (period wise) and longitudinally (cohort wise). The magnitude and the pattern of age specific rates were analyzed using the age-period-cohort analysis. The constrained generalized linear model with a priority assumption of cohort effect as contributing factor to changing rates was used to analyze the data. Result. During the last 50 years, the rate of breast cancer increased for both populations with an estimated annual percent change of 1.03% (with 95% CI of 1.029, 1.031) for Asia and 1.016% (95% CI of 1.015, 1.017) for Europe. There were stronger cohort effects in the magnitude of rates among the Asian population compared to the European population. The cohort effects, expressed as the rate ratio with cohort born in 1970 as reference, ranged from 0.06 (95% CI 0.05, 0.08) to 0.94 (95% CI 0.93, 0.96) for Asians and 0.35 (95% CI 0.33, 0.36) to 1.03 (95% CI 1.02, 1.04) for Europeans. The estimated longitudinal age specific rates (adjusted for cohort and period effects) showed similar patterns between the two populations. Conclusion. It was concluded that a strong cohort effect contributes to the younger age at onset among Asian breast cancer patients.

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TGFBR1 Polymorphism and Risk of Breast Cancer in Iranian Women

The International Journal of Biological Markers ◽

10.5301/jbm.5000102 ◽

2015 ◽

Vol 30 (4) ◽

pp. 414-417 ◽

Cited By ~ 1

Author(s):

Elahe Kamali ◽

Simin Hemmati ◽

Forouzan Safari ◽

Manoochehr Tavassoli

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Transforming Growth Factor Beta ◽

Lower Risk ◽

Transforming Growth Factor ◽

Age At Onset ◽

Epidemiological Studies ◽

Breast Cancer Patients ◽

Iranian Women ◽

Risk Of Cancer

Numerous epidemiological studies have evaluated the association between transforming growth factor beta receptor type 1 ( TGFBR1) polymorphisms and the risk of cancer; however, the results remain inconclusive and controversial. To determine the association between breast cancer risk and the *6A polymorphism of the TGFBR1 gene, a case-control study of 280 breast cancer patients and 280 controls was performed in Iranian women. Our study demonstrates that women who carry the TGFBR1*6A allele are at lower risk of developing breast cancer. The highest protection against breast cancer was observed in 6A/6A homozygotes (OR = 0.32, p = 0.04). A lower frequency of the TGFBR1*6A allele in breast cancer patients may be an important genetic determinant that contributes to a lower risk of breast cancer in Iranian women. The results also showed that the allelic length of TGFBR1 polymorphisms had no significant association with the age at onset or the grade of disease, nor with the expression of progesterone and estrogen receptors and HER2.

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Factors affecting lymphovascular invasion in node-positive breast cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.24 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 24-24

Author(s):

L. B. Cornwell ◽

K. McMasters ◽

A. B. Chagpar

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Lymph Node Status ◽

Breast Cancer Patients ◽

Extracapsular Extension ◽

Community Size ◽

Factors Affecting ◽

Younger Age ◽

Clinicopathologic Factors ◽

Pathology Reports

24 Background: Lymphatic and/or vascular invasion (LVI) is not uniformly reported in breast cancer tumors, and may be absent even in LN+ patients. The purpose of this study was to define factors associated with (a) the non-reporting of LVI, and (b) the finding of no LVI in LN+ patients. Methods: Data from 400 LN+ patients from a cohort of patients in a prospective multicenter study were reviewed. Institutional and clinicopathologic factors correlating with the reporting and finding of LVI were assessed using non-parametric statistical analysis. Results: Of the 400 LN+ patients in this cohort, LVI was not reported in 98 (24.5%) patients. Of the remaining 302 patients, LVI was reported as negative in 147 (48.7%). LVI was more often reported in later years (84.9% in 2001-2004 vs. 67.9% in 1997-2000, p<0.001). The reporting of LVI did not vary significantly by region, teaching affiliation, community size, or the surgeon’s proportion of breast practice or number of cases. Further, reporting of LVI was not associated with surgery type, patient age, number of positive nodes, size of largest metastasis, nor extracapsular extension. LVI was, however, more frequently reported in larger tumors (median tumor size 2.0 cm vs. 1.8 cm, p=0.030). Despite the finding that LVI was more frequently reported in later years, the proportion of patients found to have LVI did not vary by year (53.3% in 2001-2004 vs. 49.3% in 1997-2000, p=0.565), region, teaching affiliation, community size, or surgeon practice. LVI positivity was associated with younger age (median age 53 vs. 60, p=0.001), larger tumors (median size 2.5 vs. 1.8 cm, p<0.001), more positive lymph nodes (median 2.5 vs. 1, p<0.001), more macrometastases (58.7% vs. 36.5%, p=0.002), and more extracapsular extension (70.3% vs. 46.0%, p=0.001). Conclusions: Reporting of LVI has improved in recent years, and while the rate of LVI positivity has not changed in LN+ patients, it remains associated with poor prognostic factors in this cohort. Therefore, reporting of LVI should be encouraged as a standard part of synoptic pathology reports for breast cancer patients, regardless of lymph node status.

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NGS-Based BRCA1, BRCA2, and PALB2 Mutation Testing in Iranian Population With Breast Cancer

Journal of Global Oncology ◽

10.1200/jgo.18.84100 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 208s-208s ◽

Cited By ~ 1

Author(s):

E. Ebrahimi ◽

E. Sellars ◽

R. Shirkoohi ◽

I. Harirchi ◽

R. Ghiasvand ◽

...

Keyword(s):

Breast Cancer ◽

Genetic Testing ◽

Cancer Risk ◽

Cancer Patients ◽

Hereditary Breast Cancer ◽

Cancer Susceptibility ◽

Age At Onset ◽

Iranian Population ◽

Breast Cancer Patients ◽

Risk Criteria

Background: Identification of individuals who have a pathogenic mutation in breast cancer susceptibility genes is an important step to take advantage of genetic counseling, screening, and potentially life-saving prevention strategies. Based on the National Comprehensive Cancer Network (NCCN) guideline, genetic testing is deemed suitable for breast cancer patients with young age at onset, positive family history of cancers, male breast cancer, or diagnosis with a multifocal or triple negative breast cancer. Aim: Since, it is not known what proportion of breast cancers in Iran is hereditary and related to mutations in BRCA1/2 and PALB2 genes, therefore, we screened these 3 genes in multiethnic Iranian population to determine the spectrum of the breast cancer susceptibility gene mutations and to further assess the predictive value of the hereditary breast cancer risk criteria for genetic testing. Methods: Next generation sequencing (NGS) was conducted on a population consisted of 299 and 125 breast cancer patients, with and without hereditary cancer risk criteria for genetic testing, respectively. Results: Pathogenic mutation rate was 10.36% in patients with hereditary criteria for breast cancer vs 1.6% in no criteria group ( P = 0.002). All the patients who only met the young age at onset (<40) criterion tested negative for a gene mutation. This is while patients who had only 1 hereditary criterion (OR: 5.48, 95% CI: 1.09, 52.90, P = 0.017) and patients with multiple hereditary criteria (OR: 22.5, 95% CI: 5.19, 201.31, P < 0.0001) had a significantly higher probability of finding a mutation compared with no risk-criteria group. Conclusion: The first application of NGS on Iranian breast cancer population added to the cumulative evidence that BRCA1/2 mutations are seen commonly among Iranian breast cancer patients especially those with hereditary breast cancer criteria and indicated that PALB2 should be concerned in hereditary breast cancer screening alongside BRCA1/2. Investigating the predictive potential of hereditary breast cancer risk criteria our results suggest that offering genetic testing to women with early age at onset of <40 with no other hereditary criteria, may not be cost effective and should be considered for optimization of genetic counseling and genetic testing of the Iranian population.

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Retrospective analysis of breast cancer patients in an Asian-majority community clinic.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e12502 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e12502-e12502

Author(s):

Adriana Hu ◽

Yi-Kong Keung ◽

Ryan A Lau ◽

Lap-Woon Keung ◽

Eddie Hu

Keyword(s):

Breast Cancer ◽

Retrospective Analysis ◽

Cancer Patients ◽

Asian Population ◽

Breast Conserving Surgery ◽

Female Breast Cancer ◽

Breast Cancer Patients ◽

Asian Countries ◽

Community Clinic ◽

The Us

e12502 Background: Incidence of breast cancer in Asian countries is about one third to one half of that of the US. Asian immigrants have a higher risk of developing breast cancer in the US presumably by adopting more westernized lifestyles. We conduct a retrospective analysis of breast cancer patients (pts) in an Asian-majority community in Southern California. Methods: Unselected consecutive female breast cancer pts were studied. Clinical data were review and statistical analysis was conducted by SPSS 16.0. Results: 501 pts, 334 Asians (incl. Chinese 84%) and 167 non-Asians (incl. Caucasian 47% and Hispanic 45%) were studied. Conclusions: This study raised several intriguing findings: 1. Asian pts are significantly younger and have lower BMI than non-Asians. 2. Asian pts are more likely to undergo mastectomy than breast conserving surgery. 3. Asian pts tend to have denser breasts which may potentially limit the sensitivity of mammogram. Since the ratio of DCIS to invasive cancer is comparable between Asian and non-Asian pts in this study, mammogram is probably effective in detecting early cancer in Asians. 4. Significantly fewer Asian pts are diagnosed by screening mammogram. It is probably due to lower utilization of mammogram in the Asian population. 5. BRCA1/2 mutation is not significantly different between Asians and non-Asians. Due to inherent limitations of retrospective study, these findings need to be confirmed in a larger prospective study. [Table: see text]

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Independent and Combined Associations of 677C/T and 1298A/C Polymorphisms in the MTHFR gene with Breast Cancers in a South-Asian Population

10.1101/2021.03.13.21253512 ◽

2021 ◽

Cited By ~ 1

Author(s):

Sadia Ajaz ◽

Sani-e-Zehra Zaidi ◽

Saleema Mehboob Ali ◽

Aisha Siddiqa ◽

Muhammad Ali Memon ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

South Asian ◽

Asian Population ◽

Control Analysis ◽

Age Group ◽

Breast Cancers ◽

Breast Cancer Patients ◽

South Asian Population ◽

Cancer Management

AbstractMTHFR is a pivotal enzyme in the folic acid cycle. Two functional SNPs, rs 1801133 (677C/T) and rs 1801131 (1298A/C), which affect the function of the MTHFR, are associated with different cancers. In the present study, these SNPs were investigated in breast cancer patients from the Pakistani population. The pilot study includes 187 participants with 124 breast cancer patients and 63 medically confirmed healthy individuals as controls. PCR-RFLP methods validated by Sanger sequencing were used for the polymorphic investigations. Here, we report the significant and unique associations of these polymorphisms with breast cancers in a South-Asian population for the first time in the literature. The case-control analysis showed that in case of 1298A/C polymorphism, a significant protective effect of homozygous C genotype was observed in recessive [CC vs AA+AC; OR: 0.320 (95% CI: 0.259 – 0.397)] and co-dominant multiplicative [CC vs AA; OR 0.379 (95% CI: 0.273 – 0.527)] models. In the case of 677C/T analysis, no significant association was observed with the risk of breast cancers. However, homozygous T genotype was more frequent in the advanced age group (>35 years) patients as compared to the young age-group (<35 years) i.e. 6.7% vs 0%. Thus, carriers of this genotype are less likely to develop breast cancers at younger age. The combined genotype analysis at two loci revealed that 677CC+1298AC [OR: 2.688 (95% CI: 1.247-5.795)] and 677CT+1298AA [OR.: 20.91 (95% CI: 1.156-378.2)] increased risk of breast cancers, significantly. The latter association (677T*1298A) was also observed in a semi-parametric haplotype analysis (p-value: 0.03). Interestingly, despite the proximity, these loci were in linkage equilibrium (r2 = 0.029 and 0.049 in cases and controls, respectively). The study implies translational potentials of these polymorphisms for breast cancer management in the studied population.

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Abstract 1597: Increased circulating tumor cell (CTC) after systemic therapy is associated with younger age in stage III/IV breast cancer patients

10.1158/1538-7445.am2018-1597 ◽

2018 ◽

Cited By ~ 1

Author(s):

Qiang Zhang ◽

Lorenzo Gerratana ◽

Lisa Flaum ◽

Youbin Zhang ◽

William Gradishar ◽

...

Keyword(s):

Breast Cancer ◽

Tumor Cell ◽

Cancer Patients ◽

Systemic Therapy ◽

Circulating Tumor Cell ◽

Stage Iii ◽

Breast Cancer Patients ◽

Younger Age

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Prevalence of PALB2 Mutations in Breast Cancer Patients in Multi-Ethnic Asian Population in Malaysia and Singapore

PLoS ONE ◽

10.1371/journal.pone.0073638 ◽

2013 ◽

Vol 8 (8) ◽

pp. e73638 ◽

Cited By ~ 22

Author(s):

Sze Yee Phuah ◽

Sheau Yee Lee ◽

Peter Kang ◽

In Nee Kang ◽

Sook-Yee Yoon ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Asian Population ◽

Breast Cancer Patients

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A Retrospective Cohort Analysis of Second Breast Cancer Risk for Primary Breast Cancer Patients With an Assessment of the Effect of Radiation Therapy2

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/70.5.797 ◽

1983 ◽

Keyword(s):

Breast Cancer ◽

Radiation Therapy ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Cancer Patients ◽

Retrospective Cohort ◽

Cohort Analysis ◽

Breast Cancer Patients ◽

Retrospective Cohort Analysis ◽

Second Breast Cancer

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Clinical and pathological characteristics of triple-negative breast cancer patients: A single-center experience.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11515 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11515-e11515

Author(s):

Aydan Akdeniz ◽

Selim Yalcin ◽

Samed Rahatli ◽

Nadire Kucukoztas ◽

Mahmut Can Yagmurdur ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

University Hospital ◽

High Grade ◽

Breast Cancer Patients ◽

Pathological Characteristics ◽

Younger Age

e11515 Background: Triple negative breast cancer in which estrogen, progesterone receptors and c-erbB2 overexpression are negative, seems to have different clinical course and recurrence pattern. Methods: We evaluated retrospectively clinical demographic and pathological characteristics of triple negative breast cancers and investigated the association of these characteristics with OS and PFS. Results: 59 early stage patients with triple negative breast cancer patients followed in Baskent University Hospital between 1997-2009 were enrolled into the study. The median age of patients was 49. Median follow-up duration was 27 months (0.27-132 months). Two patients died during the follow-up. Invasive ductal carcinoma pathology was reported in 38 patients, invasive lobular in 3 patients, medullary in 5 patients.Almost half of the patients had LVI. 79% of patients had a T2 disease. 30% of patients’ tumor histological grade was III. Cancer history in the family was present in 95% of patients. Almost half of the patients had stage II disease. Adjuvant chemotherapy was given to 43 patients. Relapses were observed in 15 patients.The most common metastatic site was lung. Patients having high grade tumor, >3 (+) lymph nodes, younger age have higher chance of relapse during follow-up. Conclusions: In accordance with the literature, our triple negative breast cancer patients showed more aggressive characteristics. Although median follow-up is short, one-fourth of the patients having recurrence support natue of the triple negative breast cancer patients. In our study, triple negative patients had younger age at diagnosis, high grade tumors and more tendency to metastasize to visceral organs.

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