Estrogen Receptor Negative Breast Cancer in India: Do We Really Have Higher Burden of this Subtype?

Manjunath, Suraj; Prabhu, Jyothi S; Kaluve, Rohini; Correa, Marjorie; Sridhar, T.S.

doi:10.1007/s13193-011-0072-8

Cited by 26 publications

(23 citation statements)

References 10 publications

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“…Data from earlier studies conducted in India reveal a higher proportion of ERnegative breast cancers when compared to the US or Western Europe; the reasons for this are several - technical failures, younger age of patients, and a higher grade or advanced stage at presentation [8-13]. In our study, the overall ERpositivity was found to be 52.0%.…”

Section: Discussionsupporting

confidence: 45%

Estrogen and progesterone receptor status in breast cancer: a cross-sectional study of 450 women in Kerala, South India

2014

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BackgroundHormone receptor status is an important prognostic and therapeutic tool in breast cancer. The objectives of our study were to create a database of breast cancer patients in Central Kerala between January 2010 and December 2012 and analyze the proportions of estrogen receptor and progesterone receptor positivity in premenopausal and postmenopausal women with breast cancer.MethodsEstrogen and progesterone receptor status were evaluated by immunohistochemistry. The chi-square test was used for statistical analysis.ResultsThe median age at diagnosis was 50 years while the mean age was 51.92 (SD = 11.78). 56.1% of premenopausal and 47.4% of postmenopausal patients were found to be ER positive, while PR positivity was 47.7% and 34.7% respectively in the premenopausal and postmenopausal age groups.ConclusionsThe proportions of ER and PRnegative tumors were found to be lower than reported in earlier studies on Indian populations. Contrary to expectations, the proportions of ER and PRpositivity were found to be higher in the premenopausal age group.

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Section: Discussionsupporting

confidence: 45%

Estrogen and progesterone receptor status in breast cancer: a cross-sectional study of 450 women in Kerala, South India

2014

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“…One of the important issues is the occurrence of estrogen receptor negative (ER-) BC at earlier ages in LMICs [31] . It has been suggested that the younger age of BC in LMICs is due to the age distribution of the population [31] , although there is a possibility that the aggressive ER-BC seen in younger ages in LMICs might be a different disease subtype, as has been suggested in Asia and Africa [32,33] .…”

Section: Dey S Breast Cancer Prevention In Lmicsmentioning

confidence: 98%

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Dey¹

2014

WJCO

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To review the present status of breast cancer (BC) screening/early detection in low-and middle-income countries (LMICs) and identify the way forward, an open focused search for articles was undertaken in PubMed, Google Scholar and Google, and using a snowball technique, further articles were obtained from the reference list of initial search results. In addition, a query was put up on ResearchGate to obtain more references and find out the general opinion of experts on the topic. Experts were also personally contacted for their opinion. Breast cancer (BC) is the most common cancer in women in the world. The rise in incidence is highest in LMICs where the incidence has often been much lower than high-income countries. In spite of more women dying of cancer than pregnancy or childbirth related causes in LMICs, most of the focus and resources are devoted to maternal health. Also, the majority of women in LMICs present at late stages to a hospital to initiate treatment. A number of trials have been conducted in various LMICs regarding the use of clinical breast examination and mammography in various combinations to understand the best ways of implementing a population level screening/early detection of BC; nevertheless, more research in this area is badly needed for different LMIC specific contexts. Notably, very few LMICs have national level programs for BC prevention via screening/early detection and even stage reduction is not on the public health agenda. This is in addition to other barriers such as lack of awareness among women regarding BC and the presence of stigma, inappropriate attitudes and lack of following proper screening behavior, such as conducting breast self-examinations. The above is mixed with the apathy and lack of awareness of policy makers regarding the fact that BC prevention is much more cost-effective and humane than BC treatment. Implementation of population level programs for screening/early detection of BC, along with use of ways to improve awareness of women regarding BC, can prove critical in stemming the increasing burden of BC in LMICs. Use of newer modalities such as ultrasonography which is more suited to LMIC populations and use of mHealth for awareness creation and increasing screening compliance are much needed extra additions to the overall agenda of LMICs in preventing BC.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Breast cancer; Screening; Early detection; Mammography; Clinical breast examination; Breast self examination; Ultrasonography; Awareness; Developing countries; Low-and middle-income countries Core tip: Implementation of population level breast cancer (BC) screening/early detection programs will prove to be most cost-effective for low-and middleincome countries (LMICs). Accompanying awareness creation regarding BC among women, more research and change in policy are also necessary to reduce the burden of BC in LMICs.Dey S. Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal.

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“…The best characterized of these subtypes are luminal A, luminal B, HER2, and basallike carcinoma. Immuno-phenotyping with ER, PR, and HER2 biomarkers can be used as a surrogate for molecular category of breast cancer (13)(14)(15). Luminal sub-group constitutes approximately 70% of invasive breast cancers.…”

Section: Association Of 25-oh Vitamin D Levels With Breast Cancer Patmentioning

confidence: 99%

“…Estrogen receptor negativity is one of the poor prognostic indicators in breast cancer (13). The antiproliferative action of vitamin D in breast cancer could partly be mediated by its role in down-regulating estrogen receptor abundance in breast cancer (7,11).…”

Section: Association Of 25-oh Vitamin D Levels With Breast Cancer Patmentioning

confidence: 99%

Low serum 25-hydroxy vitamin D levels are associated with aggressive breast cancer variants and poor prognostic factors in patients with breast carcinoma

Karthikayan¹,

Sureshkumar²,

Dharanipragada³

et al. 2018

Archives of Endocrinology and Metabolism

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Objective: This study was conducted to assess the serum 25-hydroxy (OH) vitamin D levels in patients with breast cancer compared to healthy controls and to identify its association with aggressive breast cancer phenotypes. Materials and methods: Serum 25-OH vitamin D levels of 78 breast cancer patients and 78 matched healthy controls were estimated using ELISA. The cases and controls were matched with respect to age, menopausal status, parity, weight, height and co-morbidities. Prognostic factors like grade of tumour, hormone receptor status, HER2 neu status and lymphovascular invasion were compared with 25-OH vitamin D levels. Results: The mean serum 25-OH vitamin D levels of cases were significantly lower compared to the controls (22.33 ± 8.19 vs. 37.41 ± 12.9 ng/mL; p = 0.0001). Patients with higher grades of tumour, non-luminal types of breast cancer and breast cancers with estrogen receptor negativity had significantly lower serum 25-OH vitamin D levels than their opposing groups. Patients with excellent and good Nottingham's prognostic Index (NPI) had significantly higher serum 25-OH vitamin D levels than the moderate and poor NPI groups. Conclusion: Newly diagnosed breast cancer patients have significantly lower serum 25-OH vitamin D levels than healthy controls. Lower level of serum 25-OH vitamin D correlates with aggressive breast cancer phenotypes. Arch

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Estrogen Receptor Negative Breast Cancer in India: Do We Really Have Higher Burden of this Subtype?

Cited by 26 publications

References 10 publications

Estrogen and progesterone receptor status in breast cancer: a cross-sectional study of 450 women in Kerala, South India

Estrogen and progesterone receptor status in breast cancer: a cross-sectional study of 450 women in Kerala, South India

Preventing breast cancer in LMICs via screening and/or early detection: The real and the surreal

Low serum 25-hydroxy vitamin D levels are associated with aggressive breast cancer variants and poor prognostic factors in patients with breast carcinoma

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