Clinical and pathologic profile of breast cancer in a tertiary cancer center in Saudi Arabia.

Abstract

1603 Background: Breast cancer (BC) ranked first among Saudi females, accounting for 23.6% of all cancers with highest incidences in Eastern and Riyadh Regions. Our study aimed at describing the clinical, pathological and epidemiological characteristics of BC at our institution, a leading tertiary cancer center in the region. Methods: Data were collected from records of BC patients treated at King Abdulaziz Medical City over 5 year period from 2002 to 2007, including clinical, demographic, and disease characteristics. Data was analyzed using SPSS version 18. Results: 450 pathologically confirmed BC patients were identified. The median age of diagnosis was 47.8 years (13-84). The vast majority are Saudi 81%. Most of the patients are overweight (32.5%) or obese (49.0%) whereas, over 21% of them are diabetic and 20% are hypertensive, 4.5% are nulliparous, and 59% have family history of malignancy. Only four patients have previous history of malignancy. The most frequent presenting symptom is breast lump (85%) followed by axillary lump in (11%). The mean duration of symptoms was 348 days. Around 4.5% presented with bilateral tumors and the primary site of cancer was the right upper outer quadrent in nearly 40% of patients. 93% of cases are invasive ductal carcinoma and 7.1% are invasive lobular carcinoma. 2% are insitu tumor, 28% had localized disease, 35% regional involvement and 19% with distant metastasis while 16% were unknown. Finally the ER and PR were positive in 39% and 33.5%, respectively and 29.5% had positive HER2 over expressed. 14.3% were triple negative (TNBC). Conclusions: Patients with BC present at younger age and more advanced stage. The latter fact may be related to delay in seeking medical help in a timely fashion. Public outreach programs are underway to improve female awareness about the importance of screening and early detection. Higher percentage of tumors over express HER2 neu while TNBC rate is similar to Western data. High percentage of women has positive family history, overweight, and obesity which need further evaluation as BC risk factors.