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Fancellu A, Zhao XY, Cottu P, Sanna V, Li YP, Zhu Q, Tanda C, Zhang YY, Lai YM, Ginesu GC, Dai SQ, Porcu A. Comparing Clinicopathologic Features and Surgical Treatment of Premenopausal Breast Cancer across Italy and China: Report from a Medical Exchange Program. Breast Care (Basel) 2020; 15:511-518. [PMID: 33223995 DOI: 10.1159/000505448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 12/16/2019] [Indexed: 02/05/2023] Open
Abstract
Background This study investigated the differences in clinicopathologic features and surgical treatment between an Italian and a Chinese cohort of premenopausal women with breast cancer, and highlighted the potential advantages of international medical exchange projects. Methods Premenopausal women who underwent surgical treatment between 2012 and 2016 at one Italian and one Chinese institution participating in a medical exchange program were compared. Factors associated with the probability to receive mastectomy were determined via logistic analysis. Changes in surgical management at the Chinese institution in the period 2018-2019, after the exchange program, were also evaluated. Results A total of 505 patients, 318 from Italy and 187 from China, were evaluated. The Chinese patients had more frequently advanced-stage tumours, large tumour size (30.9 vs. 18.1 mm, p < 0.01), invasive carcinoma (92.5 vs. 83.3%, p < 0.01), positive axillary lymph nodes (54.5 vs. 27.4%, p < 0.01), Her-2 positivity (36.4 vs. 22.0%, p < 0.01), and high proliferative index (55.1 vs. 30.2%, p < 0.01). Positive oestrogen receptor status and rates of triple-negative breast cancer did not differ (77.0 vs. 69.5%, p = 0.09 and 14.2 vs. 16%, p = 0.56, respectively). Mastectomy rates were higher among Chinese women (85 vs. 41%, p < 0.001), whereas use of sentinel node biopsy was more frequent among Italian women (77 vs. 33%, p < 0.001). Chinese women had more than 4-fold higher risk of receiving mastectomy. In the last 2 years, the rates of breast-conserving surgery and sentinel node biopsy at the Chinese institution increased from 15 to 23%, and from 33 to 42%, respectively. Conclusions Tumour features and surgical strategies for premenopausal breast cancer may differ significantly between Italy and China. Since the international exchange program, patients from the Chinese institution have been offered more frequently less invasive surgery. International exchange programs can help in designing epidemiological studies which may be useful for strategies to improve breast cancer management and control.
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Affiliation(s)
- Alessandro Fancellu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Xue Yun Zhao
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Pietrina Cottu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Valeria Sanna
- Division of Medical Oncology, AOU Sassari, Sassari, Italy
| | - Yuan Ping Li
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Qin Zhu
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Cinzia Tanda
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ying Yi Zhang
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Yan Mei Lai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Giorgio Carlo Ginesu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Shu Qin Dai
- Department of Thyroid and Breast Surgery, People's Hospital of Leshan, Leshan, China
| | - Alberto Porcu
- Unit of General Surgery 2-Clinica Chirurgica, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Kim S, Ko Y, Lee HJ, Lim JE. Menopausal hormone therapy and the risk of breast cancer by histological type and race: a meta-analysis of randomized controlled trials and cohort studies. Breast Cancer Res Treat 2018; 170:667-675. [PMID: 29713854 DOI: 10.1007/s10549-018-4782-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 04/06/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE This meta-analysis investigated the association between the risk of breast cancer and hormone replacement therapy (HRT). Various stratified analyses were performed according to race (Asian/Westerner), HRT type [all hormone therapies, estrogen-only therapy (ET), or combined estrogen-progestin therapy (EPT)], histological breast cancer type (ductal/lobular/mixed ductal-lobular), and estrogen receptor status (ER-positive/ER-negative). METHODS A literature search was performed using Pubmed, Embase, and KoreaMed. Twenty-five epidemiological studies including 23 cohort studies and two randomized controlled trials were included in this meta-analysis. RESULTS Using a random-effects model, HRT use was found to be positively associated with the risk of breast cancer with a pooled hazard ratio (HR) of 1.33 [95% confidence interval (CI) 1.24, 1.44]. Compared with ET, EPT was more strongly associated with breast cancer risk. EPT was associated with both ductal and lobular breast cancer risks [for ductal breast cancer, HR = 1.51 (95% CI 1.28, 1.78); for lobular breast cancer, HR = 1.38 (95% CI 1.20, 1.60)]. According to ER status, all HRTs were associated with the risk of ER-positive breast cancer, but not with that of ER-negative breast cancer. CONCLUSIONS Asian HRT users had a higher risk of breast cancer than western HRT users. Both ET and EPT were significantly associated with the risk of all breast cancer histological types and ER-positive breast cancer.
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Affiliation(s)
- Sohyun Kim
- Graduate School of Industrial Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Yeonsook Ko
- Graduate School of Industrial Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Hwa Jeong Lee
- Graduate School of Industrial Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea. .,College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea.
| | - Jung-Eun Lim
- Graduate School of Industrial Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea. .,College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea. .,Institute for Health Promotion & Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
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Li S, Wang X, Yang J, Lv M, Zhang X, Li C, Zhang L, Shen Y, Zhang X, Chen Z, Wang F, Wang X, Li D, Yi M, Yang J. Clinicopathological features and survival of early stage breast cancer in northwest China: A population-based retrospective study of 1287 patients. Thorac Cancer 2017; 9:10-18. [PMID: 28976077 PMCID: PMC5754296 DOI: 10.1111/1759-7714.12503] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/05/2017] [Accepted: 08/06/2017] [Indexed: 11/27/2022] Open
Abstract
Background Breast cancer (BC) displays different clinicopathological features and outcomes based on patient age, molecular subtype, and treatment. However, such features in BC patients in northwest China are unclear. This study investigated the clinicopathological features and overall survival (OS) of early stage BC patients using a population‐based study. Methods Patients who were newly diagnosed with BC at the First Affiliated Hospital of Xi'an Jiaotong University between January 2001 and June 2012 were included. Clinicopathological features and OS were assessed. Results The median age of 1287 patients was 50 years, with an average tumor size of 2.65 cm. Additionally, 42.7% were luminal A, 25.6% luminal B, 9.3% Her2 overexpression, and 17.7% triple negative. The cut‐off age was 35 years, and young patients (< 35) tended to have larger tumors, ≥ 4 positive lymph nodes, grade 2 or 3 histology, non‐luminal types, high Ki67, and poor outcomes. Patients with luminal A tumors showed moderate features: 50.6% had tumors < 2 cm, 56.7% had negative lymph nodes. Patients with Her2 overexpression tumors showed aggressive features and the poorest survival (5‐year OS 67.6%). Patients with triple negative tumors were the youngest (average 48.4 years), but had the largest proportion of grade 3 histology and poor outcomes. Conclusion Our results are consistent with those in other provinces in China, but showed an earlier age at diagnosis and more aggressive pathological features compared to developed countries. Additionally, each molecular subtype showed specific features and different survival outcomes.
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Affiliation(s)
- Shuting Li
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiangtang Wang
- Medical Department, The Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Jiao Yang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Lv
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiao Zhang
- Department of Medical Oncology, Xianyang Central Hospital, Xianyang, China
| | - Chunli Li
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lingxiao Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanwei Shen
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xiaoman Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zheling Chen
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fan Wang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Wang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dan Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Min Yi
- Department of Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Yang
- Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Hadzijusufovic E, Willmann M. Comparing Human Breast Cancer with Canine Mammary Cancer. Comp Med 2017. [DOI: 10.1007/978-3-319-47007-8_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liaw YP, Ko PC, Jan SR, Huang JY, Nfor ON, Lung CC, Chiang YC, Yeh LT, Chou MC, Tsai HD, Hsiao YH. Implications of Type1/2 Diabetes Mellitus in Breast Cancer Development: A General Female Population-based Cohort Study. J Cancer 2015; 6:734-9. [PMID: 26185535 PMCID: PMC4504109 DOI: 10.7150/jca.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 05/25/2015] [Indexed: 12/29/2022] Open
Abstract
Aim: The current study assessed the potential impact of diabetes type 1 and type 2 for female breast cancer risk. Materials and Methods: The health information and medical record of the entire adult female residents in Taiwan were retrieved from Taiwan's National Health Insurance Research Database. Multivariate Cox proportional hazard regression models and descriptive statistics were used to identify potential correlations between type 1/2 diabetes and breast cancer. In addition, this study statistically assessed the possible association of diabetes and breast cancer risk with age, insurance amount (quality of care), and regions. Results: The diabetic status of the entire adult female population was assessed between 2001 and 2003. Of 10,827,079 adult females, 4,738 (0.04%) were diagnosed with type 1 and 830,546 (7.7%) with type 2 diabetes, and 9, 991,795 (92.3%) were free of diabetes. From 2004 to 2010, a total of 57,283 cases of breast cancer were detected, with an average breast cancer incidence rate of 0.53% in the generation population. The actual breast cancer incidence rate was 0.30% (14 of 4,738) in patients with type 1 diabetes, 1.10% (9,105 of 830,546) in patients with type 2 diabetes, and 0.48% (48,164 of 9,991,795) in patients free of diabetes. The breast cancer incidence rate is significantly higher (p < 0.001) in patients with type 2 diabetes than that in patients with type 1 diabetes and in patients free of diabetes. After adjusting for the covariates of age, insurance cost, and region, hazard ratios (HRs) for the association between breast cancer risk and types 1 and 2 DM were 1.01 (CI = 0.60-1.71) and 1.13 (CI = 1.10-1.16), respectively. Women with type 2 diabetes were at a significantly higher risk for development of breast cancer compared with those free of diabetes, but there appeared to have no significant increase in risk for those with type 1 diabetes. Our study also revealed that age, insurance amount (quality of care), and region are significantly associated with diabetes and breast cancer risk (p<0.0001). Conclusion: Our results demonstrated different implications of diabetes type for the risk of breast cancer with type 2 posing a higher risk than type 1. This is the largest cohort study that assesses the possible correlation between both type 1 and 2 diabetes with breast cancer, and also is the largest cohort study showing that diabetes are associated with age, insurance, and region, which further suggest that living condition and life style may significantly associated with diabetes and breast cancer.
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Affiliation(s)
- Yung-Po Liaw
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan ; 2. Department of Family and Community Medicine, Chung Shan Medical University Hospial, Taichung, Taiwan
| | - Pei-Chieh Ko
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Shiou-Rung Jan
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Oswald Ndi Nfor
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Chi Lung
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan ; 2. Department of Family and Community Medicine, Chung Shan Medical University Hospial, Taichung, Taiwan
| | - Yi-Chen Chiang
- 1. Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan ; 2. Department of Family and Community Medicine, Chung Shan Medical University Hospial, Taichung, Taiwan
| | - Liang-Tsai Yeh
- 3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Chih Chou
- 3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Horng-Der Tsai
- 4. Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Hsuan Hsiao
- 3. School of Medicine, Chung Shan Medical University, Taichung, Taiwan ; 4. Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
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