Breast cancer in a low‐risk population. The influence of age and menstrual status on disease pattern and survival in Saudi Arabia

Abstract

Data on 130 women with invasive breast cancer, seen at our institution between April 1981 and November 1990, were retrospectively reviewed to assess the influence of age and menstrual status on the pattern and prognosis of their disease. Patients were mostly young (median age 40 years) and in 21 patients (16%) the diagnosis was established at the age of 30 years or younger. Eighty-six patients (66%) were under 50 and 82 patients (63%) were pre-menopausal. Pre-menopausal patients were more numerous than expected in stage III and less numerous in stage II. On the other hand, the differences between observed and expected values for both stage I and stage IV in the 2 menopausal groups were not significant. Compared with post-menopausal patients, pre-menopausal patients with 1-3 or greater than 3 positive lymph nodes were more numerous than expected. Differences between pre-menopausal and post-menopausal patients have persisted after categorizing patients into 2 age-groups with a cut-off point at 50 years. Comparable initial assessment and therapeutic modalities were offered to the 2 menopausal groups. At the time of analysis (January, 1991) all patients had a complete follow-up. Over a median follow-up of 46 months, the overall median survival (+/- SE) was 85.7 (+/- 4.4) months with a survival probability (+/- SE) at 5 years of 62% (+/- 5%). The proportional hazard model of Cox has identified advanced stage (stages III and IV) and involvement of lymph nodes as the only independent adverse predictors of survival with estimated hazard rates of 2.9 and 2.8, respectively. Unadjusted analysis, adjusted analysis and stratified survival functions failed to reveal any survival difference based on age or menstrual status. We conclude that, in a low-risk population and despite apparent baseline differences in demographic and disease characteristics between pre-menopausal and post-menopausal breast cancer patients, neither age nor menopausal status had a significant influence on survival. Our results should guide future cancer-care programs in Saudi Arabia.

The Spectrum of Breast Diseases in Saudi Arab Females: A 26 Year Pathological Survey at Dhahran Health Center

“…54 There are few studies on cancer of the breast in Saudi Arab females. [23][24][25][26][27] In one study from a university teaching hospital in the Eastern Province, 25 130 females with breast cancer were studied, 80 of whom were Saudi Arabs. Their mean age was 43.4 years, which is close to our figure of 47.1 years.…”

“…[13][14][15][16][17][18][19] Few studies address themselves to the whole spectrum of breast diseases in Arab females in general. [20][21][22] Surprisingly, the subject of breast diseases in Saudi Arab females, except for a few studies, mostly on carcinoma of the breast, [22][23][24][25][26][27] has not been given its fair share of attention in the Saudi medical literature. We present here our findings in a retrospective survey of pathological material examined in our laboratory, spanning more than 26 years and giving insight into the changing pattern of breast diseases among Saudi Arab females during a period that has witnessed dramatic improvements in social and economic conditions in Saudi Arabia.…”

Breast cancer characteristics at diagnosis and survival among Arab–American women compared to European– and African–American women

“…[1][2][3][4][5][6][7][8][9][10][11][12] For example, papers from Tunisia report observations of rapidly progressing breast cancer in young women, suggestive of an inflammatory breast cancer histology. [5][6][7][8] In addition, others have reported that the majority (>50%) of breast cancer cases are diagnosed among women less than 50 [1,3,9] years of age; this is in comparison to US statistics which show that 22% of breast cancer cases are diagnosed in women under 50.…”

Current Status and Future Projections of Breast Cancer in Asia

“…In Japan, the median age at diagnosis increased from 48 years in 1946-1959 to 53.9 years in 2000-2001. Similarly, in China, the median age at diagnosis increased from 47.5 years in 1990 to 50 years in 2007 [8], and the median age at diagnosis in Saudi Arabia increased from 40 years in 1981-1990 [17] to 45 years in 2002 [15]. …”