1. Clinicopathologic Features of Breast Cancer Patients Attending Oncology Clinic in AMDI
Nurdianah HF, Nizuwan A, Muhamad Yusri M
Advanced Medical & Dental Institute (AMDI), Universiti Sains Malaysia, Penang
ABSTRACT: We conducted a pilot study to determine clinical characteristics of breast cancer (BrCa) and the association with sociodemographic factors. The research was focused on breast cancer data bank of AMDI USM from year 2004 to A total of 236 patients were diagnosed with 85.6% of them having Invasive Ductal Carcinoma (IDC) and 39.6% with Histopathology Grade 3 BrCa. Pearson Chi-Square test was performed with Ethnicity and Histopathology Grading were the only variable having associated significantly with Type of Cancer (P-value < 0.05). We conclude that Ethnicity and Histopathology Grading can be recognized as the only factor to have the association with Type of Cancer (IDC/ILC/DCIS).
Table 1: Distribution of breast cancer tumor subtypes and patient demographics
INTRODUCTION
Breast cancer is the most common cancer in women worldwide, comprising 16% of all female cancers. Prognosis and survival rates for breast cancer vary greatly depending on the cancer type, stage and treatment received. In this study, breast cancer is classified into four groups based on immunohistochemistry (IHC) profile ER/PR and Her2/neu expression, positive (+) and/or negative (-).
METHOD
Data collection: A retrospective study of 236 breast cancer cases in AMDI USM from year 2004 to 2012.
Statistical Analysis: Descriptive analysis and Pearson Chi-Square test have been used to analyse the data using SPSS software VER20.
RESULTS & DISCUSSION
According to Lim and Halimah (2004), in average 1 in 20 Malaysian women will develop breast cancer during their lifetime with the prevalence age group is years. Accordingly, our study showed 66.5% incidence of breast cancer cases occurred in women below 55 years of age (Table 1).
Among 202 patients of IDC, 11.4% of them were age less than 40 years. Majority of IDC patients were between years (53.5%). A total of 84.2% indicates of no family history on breast cancer but they were positively diagnosed of IDC.
The distribution of type of breast cancer and demographic revealed only Histopathology grading and Ethnicity gave a significant association with p-value less than It shows that Histopathology features and Ethinicity associate significantly with type of breast cancer (Table 1).
Other demographic factors did not have any significant result compared to other studies (Onitilo et. al,2009;
(n=236)
Type of Cancer
Total
t statisticsa
p-value
INVASIVE DUCTAL CARCINOMA (IDC)
INVASIVE LOBULAR CARCINOMA (ILC)
DUCTAL CARCINOMA IN SITU
(DCIS)
(%)
Age at Diagnosis (years)
≤ 40
23 (11.4)
4 (14.3)
1 (16.7) 28
1.969
0.741
41 – 55
108 (53.5)
17 (60.7)
4 (66.7)
129
≥ 55
71 (35.1)
7 (25.0) 79
202 (100)
28 (100)
6 (100)
236
Ethnicity
Malay
113 (55.9)
15 (53.6)
2 (33.3)
130
10.942
0.027
Chinese
72 (35.6)
6 (21.4) 80
Indian
17 (8.4) 26
Family History
Yes
32 (15.8)
0 (0) 36
1.154
0.562 No
170 (84.2)
24 (85.7)
200
TNM Staging
Stage 1
22 (10.9)
5 (17.9)
6.614
0.358
Stage 2
115 (56.9)
18 (64.3)
135
Stage 3
58 (28.7) 64
Stage 4
7 (3.5)
1 (3.6) 9
Histopathology Grading
Grade 1
5 (83.3) 43
19.978
0.001
Grade 2
90 (44.6)
106
Grade 3
80 (39.6) 87
Tumor Characteristics (ER)
Positive
139
4.846
0.089
Negative
87 (43.1)
10 (35.7) 97
Tumor Characteristics (PR)
14 (50.0)
131
0.662
0.718
89 (44.1)
105
Tumor Characteristics (HER2)
101 (50.0)
19 (67.9)
122
3.971
0.137
9 (32.1)
114
* p-value < 0.05 level of significant a Pearson Chi Square .
Figure 1: Clinicopathologic Features
CONCLUSION
* Triple-negative breast cancers tend to grow and spread more quickly than most other types of breast cancer. Because the tumor cells lack these certain receptors, neither hormone therapy nor drugs that target HER2 are effective treatments.
* It is an urgent need to raise an awareness of breast cancer in our society.
ACKNOWLEDGEMENT
The study was funded by a research grant from Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia.
REFERENCES
Fredholm H, Eaker S, Frisell J, Holmberg L, Fredriksson I, Lindman H (2009) Breast Cancer in Young Women: Poor Survival Despite Intensive Treatment. PLoS ONE. Volume 4:11
World Health Organization (WHO) (2013). Breast Cancer Burden. [updated 2013; cited September 2013]; Available from:
Onitilo A.A., Engel J.M., Greenlee R.T., Mukesh B.N. (2009) Breast Cancer Subtypes Based on ER/PR and Her2 Expression: Comparison of Clinicopathologic Features and Survival. Clinical Medicine & Research. 7(1/2):4-13