A Nation-Wide multicenter 10-year (1999-2008) retrospective clinical epidemiological study of female breast cancer in china

Abstract

BackgroundAccording to the very limited cancer registry, incidence and mortality rates for female breast cancer in China are regarded to be increasing especially in the metropolitan areas. Representative data on the breast cancer profile of Chinese women and its time trend over years are relatively rare. The aims of the current study are to illustrate the breast cancer profile of Chinese women in time span and to explore the current treatment approaches to female breast cancer.MethodsThis was a hospital-based nation-wide and multi-center retrospective study of female primary breast cancer cases. China was divided into 7 regions according to the geographic distribution; from each region, one tertiary hospital was selected. With the exception of January and February, one month was randomly selected to represent each year from year 1999 to 2008 at every hospital. All inpatient cases within the selected month were reviewed and related information was collected based on the designed case report form (CRF). The Cancer Hospital/Institute, Chinese Academy of Medical Sciences (CICAMS) was the leading hospital in this study.ResultsFour-thousand two-hundred and eleven cases were randomly selected from the total pool of 45,200 patients and were included in the analysis. The mean age at diagnosis was 48.7 years (s.d. = 10.5 yrs) and breast cancer peaked in age group 40-49 yrs (38.6%). The most common subtype was infiltrating ductal carcinoma (86.5%). Clinical stage I & II accounted for 60.6% of 4,211 patients. Three-thousand five-hundred and thirty-four cases had estrogen receptor (ER) and progestin receptor (PR) tests, among them, 47.9% were positive for both. Two-thousand eight-hundred and forty-nine cases had human epidermal growth factor receptor 2(HER-2) tests, 25.8% of them were HER-2 positive. Among all treatment options, surgery (96.9% (4,078/4,211)) was predominant, followed by chemotherapy (81.4% (3,428/4,211). Much less patients underwent radiotherapy (22.6% (952/4,211)) and endocrine therapy (38.0% (1,599/4,211)).ConclusionsThe younger age of breast cancer onset among Chinese women and more advanced tumor stages pose a great challenge. Adjuvant therapy, especially radiotherapy and endocrine therapy are of great unmet needs.

Socio-economic Factors Influencing Tumor Presentation and Treatment Options in Chinese Breast Cancer Patients

“…A similar trend was observed in the tumor stage distribution. By convention, TNM stages I and II are classified as early breast cancer stages (Li et al, 2011). We found that 55.6% of private sector workers, 54.2% of professionals, 48.6% of manual workers, and 35.7% of housewives presented with early stage tumors ( Table 2).…”

“…Xi'an is a city located in northwestern China that has a less developed economy. Since the First Affiliated Hospital of Medical College of Xi'an Jiaotong University is a representative hospital of this region (Li et al, 2011), the results of this study may, to some extent, reflect the current situation of areas with a less developed economy within China and thus provide a reference to help the Chinese government to develop a female breast cancer prevention program. Furthermore, as China is a developing country, the results of this study may assist other developing countries to improve their breast cancer prevention strategies.…”

“…The education levels of all patients were classified into six groups: none (i.e., having received no formal education), those having received primary, middle, high, or university and above education, and unspecified (Li et al, 2011;Norsa'adah et al, 2011).…”

Effects of Age, Breast Density and Volume on Breast Cancer Diagnosis: A Retrospective Comparison of Sensitivity of Mammography and Ultrasonography in China's Rural Areas

“…As compared with cases in some western countries, patients with breast cancer in Asia including China have their unique epidemiological characteristics and physiological features. For example, there are more patients diagnosed at the younger age, and the density of mammary tissue is higher (Fan et al, 2009;Lee et al, 2009;Han et al, 2011;Li et al, 2011). This leads to the controversy on the application of mammography.…”

Effect of lipoic acid combined with paclitaxel on breast cancer cells

“…Due to genetic factors, lifestyle, and environmental factors, the incidence of breast cancer increases yearly and is trending toward younger women. It usually has complicated etiology and multiple-organ metastasis (Li et al, 2011;Wei et al, 2013). Its incidence in China has already exceeded that of cervical cancer.…”