Breast cancer subtype and clinical characteristics in women from Peru

Abstract

IntroductionBreast cancer is a heterogeneous disease, and the distribution of the different subtypes varies by race/ethnic category in the United States and by country. Established breast cancer-associated factors impact subtype-specific risk; however, these included limited or no representation of Latin American diversity. To address this gap in knowledge, we report a description of demographic, reproductive, and lifestyle breast cancer-associated factors by age at diagnosis and disease subtype for The Peruvian Genetics and Genomics of Breast Cancer (PEGEN-BC) study.MethodsThe PEGEN-BC study is a hospital-based breast cancer cohort that includes 1943 patients diagnosed at the Instituto Nacional de Enfermedades Neoplásicas in Lima, Peru. Demographic and reproductive information, as well as lifestyle exposures, were collected with a questionnaire. Clinical data, including tumor Hormone Receptor (HR) status and Human Epidermal Growth Factor Receptor 2 (HER2) status, were abstracted from electronic medical records. Differences in proportions and mean values were tested using Chi-squared and one-way ANOVA tests, respectively. Multinomial logistic regression models were used for multivariate association analyses.ResultsThe distribution of subtypes was 52% HR+HER2-, 19% HR+HER2+, 16% HR-HER2-, and 13% HR-HER2+. Indigenous American (IA) genetic ancestry was higher, and height was lower among individuals with the HR-HER2+ subtype (80% IA vs. 76% overall, p=0.007; 152 cm vs. 153 cm overall, p=0.032, respectively). In multivariate models, IA ancestry was associated with HR-HER2+ subtype (OR=1.38,95%CI=1.06-1.79, p=0.017) and parous women showed increased risk for HR-HER2+ (OR=2.7,95%CI=1.5-4.8, p<0.001) and HR-HER2- tumors (OR=2.4,95%CI=1.5-4.0, p<0.001) compared to nulliparous women. Multiple patient and tumor characteristics differed by age at diagnosis (<50 vs. >=50), including ancestry, region of residence, family history, height, BMI, breastfeeding, parity, and stage at diagnosis (p<0.02 for all variables).DiscussionThe characteristics of the PEGEN-BC study participants do not suggest heterogeneity by tumor subtype except for IA genetic ancestry proportion, which has been previously reported. Differences by age at diagnosis were apparent and concordant with what is known about pre- and post-menopausal-specific disease risk factors. Additional studies in Peru should be developed to further understand the main contributors to the specific age of onset and molecular disease subtypes in this population and develop population-appropriate predictive models for prevention.

Detection of Breast Cancer through the Analysis of Radiographic Images Using Machine Learning: A Systematic Review

“…Finally, the number of articles was reduced to 26, which will be used to develop the systematic literature review. From the different databases, eight articles published during the year 2023 were identified [1], [3], [4], [6], [11], [13], [14], along with eight articles from the year 2022 [2], [5], [7][8][9][10], [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], all of which met the filters established in the methodology, and that is why they were selected. The will above aids in conducting the review with data from up-to-date research grounded in knowledge from subsequent years.…”

“…Another limitation of ML, according to studies [2], [7], [9], [11], [13], [14], [21][22][23][24][25][26][27][28][29], is related to data. When the amount of data increases for ML-based systems, it becomes evident that the algorithm faces issues that prevent it from functioning correctly [1]; the performance of ML-based algorithms is considered conventional [9].…”

“…An important point to highlight is that many authors prefer technologies such as DL instead of using ML [1], [2], [7], [9], [11], [13], [14], [21][22][23][24][25][26][27][28][29].…”

Oncologic anthropology: Global variations in breast cancer risk, biology, and outcome

“…Oncologic anthropology is also relevant in studying the breast cancer burden of Latina/Hispanic women internationally. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] Ancestry-associated variants have been identified that predict risk from specific breast cancer phenotypes among Latina women in the United States, in Central America, and in South America. These studies have also found that among admixed Latina women, the extent of European ancestry increases the risk of breast cancer, whereas extent of Indigenous American ancestry decreases the risk of breast cancer.…”

“…Oncologic anthropology is also relevant in studying the breast cancer burden of Latina/Hispanic women internationally 27–40 . Ancestry‐associated variants have been identified that predict risk from specific breast cancer phenotypes among Latina women in the United States, in Central America, and in South America.…”