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93TMR Cancer  2020, Vol. 3 Issue (1): 1-8    DOI: 10.12032/TMRC201800060
Clinical Cancer Research     
Breast cancer among Iraqi female in their fifth decade: a retrospective study
Dhuha Mohammed Kasib1, Manwar Abdulelah Al-Naqqash2,*(), Ahmed Salih Alshewered3
1Basra Specialist Children's Hospital, Basrah Health Directorate, Basra, Iraq
2Department of Surgery, University of Baghdad, College of Medicine/Baghdad Radiotherapy and Nuclear Medicine Center/Oncology Teaching Hospital/National Cancer Center, Baghdad Medical City Complex, Baghdad, Iraq
3Baghdad Radiotherapy and Nuclear Medicine Center, Baghdad Medical City Complex, Baghdad, Iraq.
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Highlights

This study assessed the clinical profiles of female Iraqi breast cancer patients in their fifth decade. The most common diagnosis was stage II breast cancer of the luminal A molecular subtype in Iraqi. Breast cancer incidence increases with age, and this is an important factor for the management of this disease. This article describes breast cancer incidence, survival, and breast cancer types in Iraqi women, providing an important complement to global data.

Abstract

Background: Breast cancer is a major public health concern for women around the world. Breast cancer incidence increases with age, and this is an important factor for the management of this disease. The aim of this study was to assess the clinical profiles of female Iraqi breast cancer patients in their fifth decade, and to evaluate patients’ molecular profiles and 5-year disease-free survival (DFS). Methods: A retrospective study was conducted at Baghdad Oncology Teaching Hospital between 1 January 2012 and 12 December 2016. Of 979 individuals seen, 285 were aged between 40 and 49 years. Results: The median age at diagnosis was 45 years. The highest incidence of breast cancer occurred among women in their fifth (40-49 years old) and sixth (50-59 years old) decades of life (29% and 28%, respectively). The most common stages at diagnosis were stages II and III, with 40.8% and 39.5%, respectively. Luminal A-like cancers were seen in 124 women (58.5%) and 29 women (13.7%) presented with triple-negative cancers. De novo metastatic disease comprised just 6.7% of the group studied. The median DFS was 48 months (95% CI: 41.4-54.5 months). Conclusions: The highest incidence of breast cancer occurred among women in their fifth and sixth decades of life. The most common diagnosis was stage II breast cancer of the luminal A molecular subtype. HER-2 (human epidermal growth factor receptor 2) overexpression and triple-negative were the least common subtypes. The median DFS was 48 months.



Key wordsIraqi breast cancer      Molecular classification      Luminal A-like      DFS     
Received: 13 June 2019      Published: 04 January 2020
Corresponding Authors: Manwar Abdulelah Al-Naqqash   
E-mail: abudallaham@gmail.com
Cite this article:

Dhuha Mohammed Kasib, Manwar Abdulelah Al-Naqqash, Ahmed Salih Alshewered. Breast cancer among Iraqi female in their fifth decade: a retrospective study. 93TMR Cancer, 2020, 3(1): 1-8. doi: 10.12032/TMRC201800060

URL:

https://www.tmrjournals.com/cancer/EN/10.12032/TMRC201800060     OR     https://www.tmrjournals.com/cancer/EN/Y2020/V3/I1/1

Age group Number of patient
< 40 years 152 (15%)
40-49 years 285 (29%)
50-59 years 277 (28%)
60-69 years 198 (20%)
70-79 years 59 (6%)
80 years and above 8 (0.8%)
Total 979 (100%)
Table 1 The distribution of Iraqi female breast cancer patients (n = 979)
Figure 1 The numbers of patients with breast cancer at 5th decade (n = 284)
Figure 2 BMI in 5th decade breast cancer patients (n = 191)
Molecular subtypes Number of patient
Luminal A 124 (58.5%)
Luminal B 30 (14.2%)
Her2 enriched 29 (13.7%)
Triple negative 29 (13.7%)
Total 212 (100%)
Table 2 The molecular subtype distribution in studies breast cancer patients (n = 212)
Figure 3 Pie chart of the distribution of surgical intervention (n = 284)
Figure 4 Bar chart of stages (n = 284)
Figure 5 Kaplan-Meier curve of 5 years DFS (n = 264)
1.   Berry DA, Cronin KA, Plevritis SK, et al. Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 2005, 353: 1784-1792.
doi: 10.1056/NEJMoa050518
2.   Harold JB, Jay R, DeVita HR et al. Malignant Tumors of the Breast, in Cancer Principles & Practice of Oncology, 10th Edition, 2015 Wolters Kluwer Health pp 1117.
3.   Albain KS, Allred DC, Clark GM. Breast cancer outcome and predictor of outcome: are there age differentials? J Natl Cancer Inst Monogr. 1994, 16: 35-42.
4.   Kollias J, Elston CW, Ellis IO, et al. Early-onset breast cancer-histopathological and prognostic considerations. Br J Cancer. 1997, 75: 1318-1323.
doi: 10.1038/bjc.1997.223
5.   Shannon C, Smith IE. Breast cancer in adolescents and young women. Eur J Cancer. 2003, 39: 2632-2642.
doi: 10.1016/S0959-8049(03)00669-5
6.   Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008, 26: 3324-3330
doi: 10.1200/JCO.2007.14.2471
7.   El Saghir NS, Seoud M, Khalil MK, et al. Effects of young age at presentation on survival in breast cancer. BMC Cancer. 2006, 6: 194.
doi: 10.1186/1471-2407-6-194
8.   Gajdos C, Tartter PI, Bleiweiss IJ, et al. Stage 0 to stage III breast cancer in young women. J Am Coll Surg. 2000, 190: 523-529.
doi: 10.1016/S1072-7515(00)00257-X
9.   Sorlie T, Tibshirani R, Parker J, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA 2003, 100: 8418-8423.
doi: 10.1073/pnas.0932692100
10.   Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumors. Nature 2000, 406: 747-752.
doi: 10.1038/35021093
11.   American Cancer Society. Breast Cancer Facts & Figures 2009-2010. Atlanta: American Cancer Society, 2012.
12.   Rosai and Ackerman’s Surgical Pathology; breast (chapter 20); ninth edition; volume II 2004, PP: 1763-1839.
13   Peter D, Fattaneh A (2003). World Health Organization: Tumors of the Breast and Female Genital Organs. Oxford [Oxford shire]: Oxford University Press.
14.   Al-Khafaji AH. Immunohistochemical expression of Estrogen, Progesterone receptors, P53 and Ki67 in Iraqi and Syrian breast cancer patients, A clinicopathological study. Baghdad-Iraq, 2010.
15.   Al-Alwan NAS. Clinicocytopathological evaluation of nuclear DNA ploidy and hormone receptor contents in breast tumors, a Ph.D. thesis submitted to the college of medicine and the committee of postgraduate studies of the University of Baghdad, 1998.
16.   Hassoon S. Correlation of the findings of Biofield breast cancer Diagnostic System (BDS) with clinicopathological parameters of mammary carcinoma in Iraq. 2007.
17.   Yalda MI. PCR Study of BRCA1 BRCA2 in Correlation to Immunohistochemical Expression of P53, Estrogen and Progesterone Receptor in Breast Cancer. A thesis submitted to the College of Medicine and committee of graduated studies of Baghdad University in partial fulfillment for the degree philosophy in pathology 2009.
18.   Al-Anbari SS. Correlation of the clinicopathological presentations in Iraqi breast cancer patients with the findings of biofield breast cancer diagnostic system (BDS), Her-2 and Ki-67 immunohistochemical expression, a thesis submitted to the college of medicine and the committee of postgraduate studies of the University of Baghdad in partial fulfillment of the requirement for the degree of PhD in Pathology. 2009.
19.   Al-Naqqash MA. The role of c-Myc oncogene as a prognostic marker in breast cancer patients evaluated by IHC and in situ hybridization (prospective study). Baghdad-Iraq. University of Baghdad College of Medicine, 2009.
20.   Oussama MNK. Guidelines for the early detection and screening of breast cancer: EMRO Technical Publications Series 30 World Health Organization 2006
21.   Pourzand A, Bassir AF, Hashemzadeh S, et al. Hormone receptor status in breast cancer and its relation to age and other prognostic factors. Breast Cancer (Auckl) 2011, 5: 87-92.
22.   Nelly HA, Abo-Elazm OM, Dalia B, et al. Age at diagnosis in women with non-metastatic breast cancer: Is it related to prognosis? J Egypt Natl Canc Inst 2014, 26: 23-30.
23.   Hyun-June P, Lee SK, Ryu JM, et al. Conditional disease-free survival among patients with breast cancer. Medicine 2017, 96: 1.
24.   AlZaman AS, Mughal SA, AlZaman YS, et al. Correlation between hormone receptor status and age, and its prognostic implications in breast cancer patients in Bahrain. Saudi Med J 2016, 37-42.
25.   Akbari ME, Sayad S, Khayamzadeh M, et al. Breast Cancer Status in Iran: Statistical Analysis of 3010 Cases between 1998 and 2014. Int J Breast Cancer 2017, 10.
26.   Nowikiewicz T, Wi?niewska M, Biedka M, et al. Overall survival and disease-free survival in breast cancer patients treated at the Oncology Centre in Bydgoszcz-analysis of more than six years of follow-up. Contemp Oncol (Pozn) 2015, 19: 284-289.
27.   Pulido C, Vendrell I, Ferreira AR, et al. Bone metastasis risk factors in breast cancer, e-cancer 2017, 11: 715.
28.   Cheang MC, Chia SK, Voduc D et al. Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 2009, 101: 736-750.
doi: 10.1093/jnci/djp082
29.   Al-Sarraf FS. Immunohistochemical Expression of ER, PR, Her2/neu, and Ki67 in Breast Carcinoma. Clinicopathological Study. Baghdad-Iraq, 2015.
30.   El- Fatemi H, Chahbounil S. Luminal B tumors are the most frequent molecular subtype in breast cancer of North African women: an immunohistochemical profile study from Morocco. Diagnostic pathology. 2012, 7: 170.
doi: 10.1186/1746-1596-7-170
31.   Diniz RW, Guerra MR, Cintra JRD, et al. Disease-free survival in patients with non-metastatic breast cancer. Rev Assoc Med Bras 2016, 62: 407-413.
doi: 10.1590/1806-9282.62.05.407
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