Abstract
Background and objectiveWe evaluated clinicopathological changes of breast cancer (BC) during a 22-year time period among the Iranian population.MethodsThis study is part of the largest BC registry in Iran. Patients were categorized as those diagnosed with BC during 1993–2005, 2006–2011, and 2012–2017 and compared regarding baseline characteristics and socioeconomical determinants, and obstetrical/gynecological and BC characteristics.ResultsOverall, 688, 1871, and 3020 patients entered the 1993–2005, 2006–2012, and 2012–2017 year groups, respectively. Mean (SD) age at first presentation of BC increased throughout the year groups (47.40 ± 10.34, 49.12 ± 11.70, and 49.43 ± 12.07 years, respectively; p < 0.001). Mean (SD) tumor size increased from 1993–2005 to 2006–2011 and decreased onto 2012–2017 (2.82 ± 1.69, 2.91 ± 1.49, and 2.66 ± 1.52 cm, respectively; p < 0.001). Number of individuals with stage 4 and grade 3 BC also showed an increasing pattern (p < 0.001). Tumor necrosis rates showed an increase onto 2011–2017 (43%, 47.3%, and 56%, respectively; p < 0.001). ER positive (62.4%, 73.4%, and 77.1%, respectively; p < 0.001) and PR positive individuals (59.5%, 64.3%, 72.6%, respectively; p < 0.001) showed an increasing trend. HER2 positive expression rates increased from 1993–2005 to 2005–2011 (24.5% and 31.5%, respectively) and decreased onto 2012–2017 (31.5% and 26.8%, respectively, p < 0.001). Number of involved lymph nodes increased (5.70 ± 6.56, 5.65 ± 6.00, and 5.95 ± 6.99, respectively; p < 0.001). Pattern of BC invasion and recurrence showed significant change (p < 0.001).ConclusionClinical and pathological characteristics may be showing a changing pattern among the Iranian population.
Highlights
Breast cancer (BC) is among the most common types of cancers among women in both developed and developing countries [1]
According to the US National Breast Cancer coalition, if a change is not implemented in the current trend of BC, on a global scale an estimated 750, 000 women will die from the disease until 2030 [2]
Inhere using data from the largest BC registry in Iran, we aimed to evaluate pattern of changes related to baseline and clinicopathological characteristics during a 22year time period in a comprehensive manner among a large sample of the Iranian population
Summary
Breast cancer (BC) is among the most common types of cancers among women in both developed and developing countries [1]. According to the US National Breast Cancer coalition, if a change is not implemented in the current trend of BC, on a global scale an estimated 750, 000 women will die from the disease until 2030 [2]. In. Due to changes in life style, urbanization, nutrition, and environmental factors, BCs are showing a changing pattern in the world [4]. The pattern of changes has been variable in most regions of the world depending on socioeconomic, clinical, and genetic factors [5,6,7]. Changes have included multiple clinical and pathological aspects of BC including esterogene (ER) receptor, progesterone (PR) receptor, and human epidermal growth receptor 2 (HER2) expression status, age of first presentation, and treatment-related characteristics [7, 8]. We evaluated clinicopathological changes of breast cancer (BC) during a 22-year time period among the Iranian population
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