Comparison of epidemiological features, clinicopathological features, and treatments between premenopausal and postmenopausal female breast cancer patients in western China: a retrospective multicenter study of 15,389 female patients

Abstract

Premenopausal and postmenopausal breast cancers are considered different types. Thus, this study aimed to explore differences in risk factors, epidemiological features, clinicopathological features, and treatment modes of premenopausal breast cancer compared to postmenopausal patients in western China. This was a hospital‐based, retrospective, multicenter epidemiological study of patients with breast cancer. Using the Western China Clinical Cooperation Group database, we obtained the records of 15,389 female breast cancers between January 2010 and April 2017. These patients were divided into premenopausal and postmenopausal groups, and their risk factors, epidemiological feature, clinicopathological features, and treatment modes were compared. Chi‐square tests, t‐test, and the multivariate logistic regression analysis were applied for statistical analysis. A total of 8395 patients were categorized as premenopausal, and 6994 patients were categorized as postmenopausal. Their risk factors, epidemiological features, clinicopathological features, and treatment modes were compared. Premenopausal patients with breast cancer had a greater tumor diameter at diagnosis (P = 0.008); higher rates of estrogen receptor (ER) expression (P < 0.0001), progesterone receptor (PR) expression (P < 0.0001), negative human epidermal growth factor receptor 2 (HER2) expression (P = 0.015), and negative P53 expression (P < 0.0001); and higher proportions of receiving breast‐conserving surgery and breast reconstruction (P < 0.0001), chemotherapy (P < 0.0001), radiotherapy (P < 0.0001), and endocrine therapy (P < 0.0001). The ethnicity, age at menarche, marital status, number of pregnancies, and number of births were the risk factors for age at diagnosis of breast cancer before or after menopause in western China. We found that the fall in the fertility rate, early menarche age, married, and less breastfeeding might have increased the possibility of premenopausal breast cancer. Significant differences exist in the tumor size, hormone receptor state, HER2 expression, epidemiological features, and treatment modes between premenopausal and postmenopausal female breast cancer patients in western China. Its further implementation requires prospective clinical testing.

Comparison of clinicopathological features and treatments between pre- and postmenopausal female breast cancer patients – a retrospective study

“…Patients with premenopausal breast cancer constituted 54.9% of all patients in our study. Similar rates were found in studies conducted in Asia, at 54.3-54.55% [17, 18].…”

“…In our study, OR positivity was high in both premenopausal women and postmenopausal women. OR positivity was 68.94% in the premenopausal group and 54.92% in the postmenopausal group; Feng et al found 59% in the premenopausal group and 55% in the postmenopausal group in their study [17]. In the premenopausal group, OR+ PR+ patients were at a higher rate, whereas in the postmenopausal group OR– PR– patients were higher.…”

Analysis of breast cancer cases according to county-level poverty status in 3.5 million rural women who participated in a breast cancer screening program of Hunan province, China from 2016 to 2018

“…Ma et al reported that the age of menarche among healthy urban Chinese girls decreased from 13.5 years in 1979 to 12.27 years between 2003 and 2005. [ 25 ] Age at menarche (>13 years compared with ≤13 years) was not found to be a risk factor after adjusting for all the variables with differences in the single logistic regression analysis in our study. Studies over the past several decades have indicated that individuals living in less-developed areas often had poorer general health than individuals living in relatively developed areas.…”

Comparing Clinicopathologic Features and Surgical Treatment of Premenopausal Breast Cancer across Italy and China: Report from a Medical Exchange Program

“…The reasons behind these findings are various and complex and include diversity in tumour genetics, cultural and demographic variables, as well as differences in health policies [3, 5, 6]. Although the incidence rates of breast cancer in Asia are lower than in western countries, they have been increasing recently [3, 7-9]. The rapid increase in the incidence of the disease is a reason for concern in China, especially in urban areas [10].…”