Breast Cancer Stage and Molecular Subtype Distribution: Real-world Insights from a Regional Oncological Center in Hungary

Overview

Journal Discov Oncol

Publisher Springer

Specialty Oncology

Date 2024 Jun 22

PMID 38907840

Authors

Judit Tittmann

Tamas Agh

Dalma Erdosi

Bettina Csanady

Erika Kover

Antal Zemplenyi

Sandor Kovacs

Zoltan Voko

Affiliations

Soon will be listed here.

Abstract

Objective: Examining the distribution of breast cancer (BC) stage and molecular subtype among women aged below (< 45 years), within (45-65 years), and above (> 65 years) the recommended screening age range helps to understand the screening program's characteristics and contributes to enhancing the effectiveness of BC screening programs.

Methods: In this retrospective study, female patients with newly diagnosed BC from 2010 to 2020 were identified. The distribution of cases in terms of TNM stages, severity classes, and subtypes was analysed according to age groups.

Results: A total of 3282 women diagnosed with BC were included in the analysis. Among these cases 51.4% were detected outside the screening age group, and these were characterized by a higher TNM stage compared to those diagnosed within the screening age band. We observed significantly higher relative frequency of advanced BC in the older age group compared to both the screening age population and women younger than 45 years (14.9% vs. 8.7% and 7.7%, P < 0.001). HR-/HER2- and HER+ tumours were relatively more frequent among women under age 45 years (HR-/HER2-: 23.6%, HER2+: 20.5%) compared to those within the screening age range (HR-/HER2-: 13.4%, HER2+: 13.9%) and the older age group (HR-/HER2-: 10.4%, HER2+: 11.5%).

Conclusions: The findings of our study shed light on potential areas for the improvement of BC screening programs (e.g., extending screening age group, adjusting screening frequency based on molecular subtype risk status) in Hungary and internationally, as well.

References

Acheampong T, Kehm R, Terry M, Argov E, Tehranifar P . Incidence Trends of Breast Cancer Molecular Subtypes by Age and Race/Ethnicity in the US From 2010 to 2016. JAMA Netw Open. 2020; 3(8):e2013226. PMC: 7431997. DOI: 10.1001/jamanetworkopen.2020.13226. View

Johansson A, Trewin C, Hjerkind K, Ellingjord-Dale M, Johannesen T, Ursin G . Breast cancer-specific survival by clinical subtype after 7 years follow-up of young and elderly women in a nationwide cohort. Int J Cancer. 2018; 144(6):1251-1261. DOI: 10.1002/ijc.31950. View

Linsell L, Forbes L, Kapari M, Burgess C, Omar L, Tucker L . A randomised controlled trial of an intervention to promote early presentation of breast cancer in older women: effect on breast cancer awareness. Br J Cancer. 2009; 101 Suppl 2:S40-8. PMC: 2790707. DOI: 10.1038/sj.bjc.6605389. View

Perron L, Chang S, Daigle J, Vandal N, Theberge I, Diorio C . Breast cancer subtype and screening sensitivity in the Quebec Mammography Screening Program. J Med Screen. 2018; 26(3):154-161. DOI: 10.1177/0969141318816736. View

Baranska A, Dolar-Szczasny J, Kanadys W, Kinik W, Ceglarska D, Religioni U . Oral Contraceptive Use and Breast Cancer Risk According to Molecular Subtypes Status: A Systematic Review and Meta-Analysis of Case-Control Studies. Cancers (Basel). 2022; 14(3). PMC: 8833678. DOI: 10.3390/cancers14030574. View

Cortet M, Bertaut A, Molinie F, Bara S, Beltjens F, Coutant C . Trends in molecular subtypes of breast cancer: description of incidence rates between 2007 and 2012 from three French registries. BMC Cancer. 2018; 18(1):161. PMC: 5804056. DOI: 10.1186/s12885-018-4080-8. View

Ian T, Tan E, Chotai N . Role of mammogram and ultrasound imaging in predicting breast cancer subtypes in screening and symptomatic patients. World J Clin Oncol. 2021; 12(9):808-822. PMC: 8479344. DOI: 10.5306/wjco.v12.i9.808. View

Huang J, Lin Q, Cui C, Fei J, Su X, Li L . Correlation between imaging features and molecular subtypes of breast cancer in young women (≤30 years old). Jpn J Radiol. 2020; 38(11):1062-1074. DOI: 10.1007/s11604-020-01001-8. View

Mangone L, Bisceglia I, Michiara M, Musolino A, Mazzoleni G, Caldarella A . Breast Cancer in Italy: Stage and Region Distribution. Breast Cancer (Dove Med Press). 2022; 14:125-131. PMC: 9064450. DOI: 10.2147/BCTT.S360244. View

10.

Kiss Z, Kocsis J, Nikolenyi A, Horvath Z, Knollmajer K, Benedek A . Opposite trends in incidence of breast cancer in young and old female cohorts in Hungary and the impact of the Covid-19 pandemic: a nationwide study between 2011-2020. Front Oncol. 2023; 13:1182170. PMC: 10545848. DOI: 10.3389/fonc.2023.1182170. View

11.

Giuliano A, Edge S, Hortobagyi G . Eighth Edition of the AJCC Cancer Staging Manual: Breast Cancer. Ann Surg Oncol. 2018; 25(7):1783-1785. DOI: 10.1245/s10434-018-6486-6. View

12.

Sha Y, Chen J . MRI-based radiomics for the diagnosis of triple-negative breast cancer: a meta-analysis. Clin Radiol. 2022; 77(9):655-663. DOI: 10.1016/j.crad.2022.04.015. View

13.

Kim H, Kim S, Freedman R, Partridge A . The impact of young age at diagnosis (age <40 years) on prognosis varies by breast cancer subtype: A U.S. SEER database analysis. Breast. 2021; 61:77-83. PMC: 8693310. DOI: 10.1016/j.breast.2021.12.006. View

14.

Rashmi S, Kamala S, Murthy S, Kotha S, Rao Y, Chaudhary K . Predicting the molecular subtype of breast cancer based on mammography and ultrasound findings. Indian J Radiol Imaging. 2018; 28(3):354-361. PMC: 6176670. DOI: 10.4103/ijri.IJRI_78_18. View

15.

Kramp L, Mathiak M, Behrens H, Schafer F, van Mackelenbergh M, Rocken C . The age-specific differences in histopathological tumor characteristics and TNM classification of breast carcinomas in Quality assured mamma diagnostic (QuaMaDi) program in the state of Schleswig-Holstein in Germany. J Cancer Res Clin Oncol. 2021; 148(2):387-400. PMC: 8800883. DOI: 10.1007/s00432-021-03841-x. View

16.

Conti B, Bochaton A, Charreire H, Kitzis-Bonsang H, Despres C, Baffert S . Influence of geographic access and socioeconomic characteristics on breast cancer outcomes: A systematic review. PLoS One. 2022; 17(7):e0271319. PMC: 9295987. DOI: 10.1371/journal.pone.0271319. View

17.

Medina M, Oza G, Sharma A, Arriaga L, Hernandez Hernandez J, Rotello V . Triple-Negative Breast Cancer: A Review of Conventional and Advanced Therapeutic Strategies. Int J Environ Res Public Health. 2020; 17(6). PMC: 7143295. DOI: 10.3390/ijerph17062078. View

18.

Laczo A, Bodis J, Bogner P, Molnar K, Vajda R, Ponusz-Kovacs D . [Participation indicators of organized mammography screening in Hungary between 2012-2021]. Magy Onkol. 2022; 66(3):195-200. View

19.

Kaminska M, Ciszewski T, Lopacka-Szatan K, Miotla P, Staroslawska E . Breast cancer risk factors. Prz Menopauzalny. 2015; 14(3):196-202. PMC: 4612558. DOI: 10.5114/pm.2015.54346. View

20.

Hassaine Y, Jacquet E, Seigneurin A, Delafosse P . Evolution of breast cancer incidence in young women in a French registry from 1990 to 2018: Towards a change in screening strategy?. Breast Cancer Res. 2022; 24(1):87. PMC: 9724405. DOI: 10.1186/s13058-022-01581-5. View