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Category: Volume 07 Issue 06 June 2019
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Title: Epidemiology of Breast Cancer in a Single Institute in North India with High Incidence of Triple Negative Breast Cancers

Authors: Mahajan R, Hakim A, Inampudi P, Pandey A, Seam RK, Sharma SC

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.110

Abstract

Introduction: Carcinoma of breast is the most frequently diagnosed cancer in the most of the countries and is also the leading cause of cancer death. Breast cancer is the most common cancer in India with ASR incidence 24.7/100,000 and mortality 13.4/100.000. Triple Negative Breast Cancers (TNBC) are regarded as one of the malignant phenotypes, principally accounting for 12-25% of invasive breast cancers.

Material and Methods: Patients data was collected from hospital registry in our Institute Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala in Haryana from period 2015 to Dec 2018. All diagnosed cases of breast cancer were included in study. A total of 153 cases were registered. All patients had pathological diagnosis. Out of 153 patients 83 patients had IHC available.

Results: In this study 153 patients were reviewed. The median age of presentation was 50 years (range 30-85). Around 27% patients were younger than 40 years. 52% patients were in age group 40-60 while 20% were above age 60. Most of patients had tumor size less than 5cm (38%) while 33% patients had tumor size more than 5cm. Majority of patients presented with lump in breast followed by pain and discharge. complete IHC done revealed ER positivity in 13.7%, PR positivity 12.4% and HER2 Neu receptor positivity in 10%. In this study incidence of TNBC is 43%. Majority of patients had Intraductal Carcinoma (>90%). Pathologically 57% patients had grade III tumor while 35% were grade II tumor.

Incidence of TNBC is 43% in this study.

Conclusion: Breast cancer is the most common cancer in India. In our study it was observed that most of the patients were 40-60 years age. Majority of the patients had grade III tumor. Incidence of TNBC was found to be higher in our study. Larger dadta is required for conclusive results.

Keywords: TNBC, North India.

References

  1. Bray F, Ferlay J, et al. Globocan Cancer Statistics 2018: Globocan Estimates of Incidence and Mortality Worldwide for 36 cancers in 185 Countries. CA: Cancer J Clin. 2018; 0:1-31.
  2. Ziegler RG, Hoover RN, Pike MC, et al. Migration patterns and breast cancer risk in Asian-American women. J Natl Cancer Inst.1993;85:1819-1827.
  3. Brinton LA, Gaudet MM, Gierach GL. Breast cancer. In: Thun MJ, Linet MS, Cerhan JR, Haiman CA, Schottenfeld D, eds. Cancer Epidemiology and Prevention. 4th ed. New York: Oxford University Press; 2018:861-888.
  4. Malvia S, Bagadi SA, Dubey US, Saxena S et al. Epidemiology of breast Cancer in Indian women. Asia-Pac J ClinOncol 2017; 13:289-295.
  5. Foulkes WD, Smith IE, Reis-Filho JS: Triple-negative breast cancer. N Engl J Med 2010, 363:1938-1948.
  6. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H,Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Lonning PE, Borresen-Dale AL:Gene expression patterns of breast carcinomas distinguish tumorsubclasses with clinical implications. Proc Natl AcadSci U S A 2001, 98:10869-10874.
  7. Dietze EC, Sistrunk C, Miranda-Carboni G, O’Regan R, Seewaldt VL: Triple-negative breast cancer in African-American women: disparities versus biology. Nat Rev Cancer 2015, 15:248-254.
  8. Khokhar A: Breast cancer in India: Where do we stand and where do we go? Asian Pac J Cancer Prev 13:4861-4866, 2012.
  9. Allemani C, Weir HK, Carreira H, et al: Global surveillance of cancer survival 1995-2009: Analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet 385:977-1010,2015
  10. Chopra B,Kaur V, Singh K,VermaM, Singh S, Singh A.Age shift: breast cancer is occurring in younger age groups—is it true? Clin Cancer Investig J 2014; 3: 526–29.
  11. Thangjam S, Laishram RS, Debnath K. Breast carcinoma in young females below the age of 40 years: a histopathological perspective. South Asian J Cancer 2014; 3: 97–100.
  12. Sandhu D, Sandhu S, Karwasra R, Marwah S. Profile of breast cancer patients at a tertiary care hospital in north India. Indian J Cancer 2010; 47: 16–22.
  13. Chopra B,Kaur V, Singh K. Age shift: Breast cancer is occurring in younger age groups: Is it true? Clin Cancer Investig J 2014; 3: 526–9.
  14. National Cancer Registry Programme 2007—2011. Indian Council of Medical Research (ICMR), Bangalore, India 2013
  15. Pakseresht S, Ingle G, Bahadur A et al. Risk factors with breast cancer among women in Delhi. Indian J Cancer 2009; 46: 132–38.
  16. Dey S, Boffetta P, Mathews A, Brennan P, Soliman A, Mathew A. Risk factors according to estrogen receptor status of breast cancer patients in Trivandrum, South India. Int J Cancer 2009; 125: 1663–70.
  17. Gajalakshmi V, Mathew A, Brennan P et al. Breastfeeding and breast cancer risk in India: a multicenter case-control study. Int J Cancer 2009; 125: 662–5.
  18. Nagrani RT, Budukh A, Koyande S, Panse NS, Mhatre SS, Badwe R. Rural urban differences in breast cancer in India. Indian J Cancer 2014; 51: 277–81.
  19. Chopra R. The Indian scene. J ClinOncol. 2001;19:106S-11S.
  20. Agarwal G, Ramakant P. Breast Cancer Care in India: The Current Scenario and the Challenges for the Future. Breast Care (Basel). 2008;3(1):21-7.
  21. Kaul R, Sharma J, Minhas SS, Mardi K. Hormone Receptor Status of Breast Cancer in the Himalayan Region of Northern India. The Indian Journal of Surgery. 2011;73(1):9-12.
  22. Ambroise M, Ghosh M, Mallikarjuna VS, Kurian A. Immunohistochemical profile of breast cancer patients at a tertiary care hospital in South India. Asian Pac J Cancer Prev. 2011;12:625-9.
  23. Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF. Hormone receptor status of breast cancer in India: A study of 798 tumours. Breast. 2000;9:267-70
  24. Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Parmar V, et al. Hormone receptors over the last 8 years in a cancer referral center in India: What was and what is? Indian J PatholMicrobiol. 2009;52:171-4.
  25. Sofi GN, Sofi JN, Nadeem R, Shiekh RY, Khan FA, Sofi AA, et al. Estrogen receptor and progesterone receptor status in breast cancer in relation to age, histological grade, size of lesion and lymph node involvement. Asian Pac J Cancer Prev. 2012;13(10):5047-52.
  26. Foulkes WD, Smith IE, Reis-Filho JS: Triple-negative breast cancer. N Engl J Med 363:1938-1948, 2010
  27. Boyle P: Triple-negative breast cancer: Epidemiological considerations and recommendations. Ann Oncol 23 (suppl 6):vi7-vi12, 2012
  28. Brewster AM, Chavez-MacGregor M, Brown P: Epidemiology, biology, and treatment of triple-negative breast cancer in women of African ancestry. Lancet Oncol 15:e625-e634, 2014
  29. Bauer KR, Brown M, Cress RD, et al: Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: A populationbased study from the California Cancer Registry. Cancer 109:1721-1728, 2007
  30. Sandhu GS, Erqou S, Patterson H, Mathew a et al: Prevalence of triple negative breast cancer in India: systemic review and Meta analysis: J Glob 2016 Jun29; 2(6); 412-421.
  31. Trivers KF, Lund MJ, Porter PL, et al: The epidemiology of triple-negative breast cancer, including race. Cancer Causes Control 20:1071-1082, 2009
  32. Amirikia KC, Mills P, Bush J, et al: Higher population-based incidence rates of triple-negative breast cancer among young African-American women: Implications for breast cancer screening recommen-dations Cancer 117:2747- 2753, 201.
  33. Stead LA, Lash TL, Sobieraj JE, et al: Triple-negative breast cancers are increased in black women regardless of age or body mass index. Breast Cancer Res 11:R18, 2009.
  34. Stark A, Kleer CG, Martin I, et al: African ancestry and higher prevalence of triple-negative breast cancer: Findings from an international study. Cancer 116:4926-4932, 2010.

Corresponding Author

Hakim A

Department of Radiotherapy and Oncology, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala, Haryana, INDIA