Comparison between the Young and Elderly Diagnosed Patients of Carcinoma of the Breast
Breast Carcinoma in Young and Elderly Patients
DOI:
https://doi.org/10.54393/pjhs.v5i01.1247Keywords:
Breast Cancer, Ductal Carcinoma, Estrogen Receptor, ProgesteroneAbstract
Breast cancer presents a significant health challenge in Pakistan, marked by high incidence rates and specific cultural and societal barriers to early detection and treatment. Objective: To compare diagnosed cases of CA breast in younger and older patients in terms of mode of presentation, TNM stage at presentation, histological variety and hormonal status. Methods: In our prospective comparative study conducted at the Department of Surgery, Bahawal Victoria Hospital, Bahawalpur, we included a total of 220 breast cancer patients aged 20 years and above. Patients were stratified into two distinct age groups for comparison: younger patients (aged less than or equal to 35 years) and older patients (aged more than 35 years). Modes of presentation, histological types, and hormonal receptor statuses were compared between the both groups. Results: In a study of 220 breast cancer patients with a mean age of 42.97 years, younger patients (≤35 years) constituted 24%, while older patients (>35 years) made up 76%. The most common presentation was lump formation (78.18%), mainly in older patients. Ulceration was evenly distributed across age groups. Histologically, invasive ductal carcinoma Grade III was more frequent in older patients, whereas Ductal Carcinoma In Situ (DCIS) was exclusive to younger patients, underscoring distinct age-related disease patterns. Conclusions: Our study revealed significant age-related differences in breast cancer presentation among Pakistani patients. Older patients (>35 years) predominantly presented with lump formation, suggesting diagnostic delays, while all younger patients (≤35 years) had DCIS, indicating possible early detection or unique tumor biology. Additionally, older patients exhibited higher ER and PR positivity.
References
Saeed S, Asim M, Sohail MM. Fears and barriers: problems in breast cancer diagnosis and treatment in Pakistan. BMC Women's Health. 2021 Dec; 21(1): 1-0. doi: 10.1186/s12905-021-01293-6. DOI: https://doi.org/10.1186/s12905-021-01293-6
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. International Journal of Cancer. 2010 Dec; 127(12): 2893-917. doi: 10.1002/ijc.25516. DOI: https://doi.org/10.1002/ijc.25516
Khan NH, Duan SF, Wu DD, Ji XY. Better reporting and awareness campaigns needed for breast cancer in Pakistani women. Cancer Management and Research. 2021 Mar: 2125-9. doi: 10.2147/CMAR.S270671. DOI: https://doi.org/10.2147/CMAR.S270671
Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. The Breast. 2022 Dec; 66: 15-23. doi: 10.1016/j.breast.2022.08.010. DOI: https://doi.org/10.1016/j.breast.2022.08.010
Menhas R and Shumaila UM. Breast cancer among Pakistani women. Iranian Journal of Public Health. 2015 Apr; 44(4): 586.
Momenimovahed Z and Salehiniya H. Epidemiological characteristics of and risk factors for breast cancer in the world. Breast Cancer: Targets and Therapy. 2019 Apr: 151-64. doi: 10.2147/BCTT.S176070. DOI: https://doi.org/10.2147/BCTT.S176070
Zaheer S, Shah N, Maqbool SA, Soomro NM. Estimates of past and future time trends in age-specific breast cancer incidence among women in Karachi, Pakistan: 2004–2025. BMC Public Health. 2019 Dec;19: 1-9. doi: 10.1186/s12889-019-7330-z. DOI: https://doi.org/10.1186/s12889-019-7330-z
Łukasiewicz S, Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast cancer—epidemiology, risk factors, classification, prognostic markers, and current treatment strategies—an updated review. Cancers. 2021 Aug; 13(17): 4287. doi: 10.3390/cancers13174287. DOI: https://doi.org/10.3390/cancers13174287
Feng Y, Spezia M, Huang S, Yuan C, Zeng Z, Zhang L, et al. Breast cancer development and progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes & Diseases. 2018 Jun; 5(2): 77-106. doi: 10.1016/j.gendis.2018.05.001. DOI: https://doi.org/10.1016/j.gendis.2018.05.001
Siadati S, Sharbatdaran M, Nikbakhsh N, Ghaemian N. Correlation of ER, PR and HER-2/Neu with other prognostic factors in infiltrating ductal carcinoma of breast. Iranian Journal of Pathology. 2015; 10(3): 221.
Zeeshan S, Ali B, Ahmad K, Chagpar AB, Sattar AK. Clinicopathological features of young versus older patients with breast cancer at a single Pakistani institution and a comparison with a national US database. Journal of Global Oncology. 2019 Mar; 5: 1-6. doi: 10.1200/JGO.18.00208. DOI: https://doi.org/10.1200/JGO.18.00208
Abdel-Razeq H, Iweir S, Abdel-Razeq R, Rahman FA, Almasri H, Bater R, et al. Differences in clinicopathological characteristics, treatment, and survival outcomes between older and younger breast cancer patients. Scientific Reports. 2021 Jul; 11(1): 14340. doi: 10.1038/s41598-021-93676-w. DOI: https://doi.org/10.1038/s41598-021-93676-w
Fernandopulle SM, Ang PC, Tan PH. Breast carcinoma in women 35 years and younger: a pathological study. Pathology. 2006 Jun; 38(3): 219-22. doi: 10.1080/00313020600699268. DOI: https://doi.org/10.1080/00313020600699268
Plichta JK, Thomas SM, Vernon R, Fayanju OM, Rosenberger LH, Hyslop T, et al. Breast cancer tumor histopathology, stage at presentation, and treatment in the extremes of age. Breast Cancer Research and Treatment. 2020 Feb; 180: 227-35. doi: 10.1007/s10549-020-05542-4. DOI: https://doi.org/10.1007/s10549-020-05542-4
Tzikas AK, Nemes S, Linderholm BK. A comparison between young and old patients with triple-negative breast cancer: biology, survival and metastatic patterns. Breast Cancer Research and Treatment. 2020 Aug; 182: 643-54. doi: 10.1007/s10549-020-05727-x. DOI: https://doi.org/10.1007/s10549-020-05727-x
Rudra S, Yu DS, Yu ES, Switchenko JM, Mister D, Torres MA. Locoregional and distant recurrence patterns in young versus elderly women treated for breast cancer. International Journal of Breast Cancer. 2015 Apr; 2015. doi: 10.1155/2015/213123. DOI: https://doi.org/10.1155/2015/213123
Schaffar R, Bouchardy C, Chappuis PO, Bodmer A, Benhamou S, Rapiti E. A population-based cohort of young women diagnosed with breast cancer in Geneva, Switzerland. PLOS ONE. 2019 Sep; 14(9): e0222136. doi: 10.1371/journal.pone.0222136. DOI: https://doi.org/10.1371/journal.pone.0222136
Alwan NA, Kerr D, Al-Okati D, Pezella F, Tawfeeq FN. Comparative study on the clinicopathological profiles of breast cancer among Iraqi and British patients. The Open Public Health Journal. 2018 May; 11(1). doi: 10.2174/1874944501811010177. DOI: https://doi.org/10.2174/1874944501811010177
Latif S, Perveen S, Iqbal M, Ahmed T, Bux KM, Jafri SN, et al. Epidemiology of Carcinoma Breast in Young Adolescence Women. Cureus. 2022 Mar; 14(3). doi: 10.7759/cureus.23683. DOI: https://doi.org/10.7759/cureus.23683
Chlebowski RT and Aragaki AK. The Women's Health Initiative randomized trials of menopausal hormone therapy and breast cancer: findings in context. Menopause. 2023 Apr; 30(4):454-61. doi: .1097/GME.0000000000002154. DOI: https://doi.org/10.1097/GME.0000000000002154
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments