Advertisement

Indian Journal of Surgery

, Volume 81, Issue 5, pp 426–431 | Cite as

Is Breast Cancer Problem in India Worse Than That of the West? Reflection of Analysis of Breast Cancer Molecular Subtyping from Tertiary Cancer Care Center in Northern India

  • Jeetendar ParyaniEmail author
  • Sameer Gupta
Original Article
  • 48 Downloads

Abstract

Breast cancer in India is rapidly expanding overtaking cervical cancer in terms of incidence as well as mortality. Indian women with breast cancer are younger, premenopausal and a large proportion of patients present at advanced stages. Considering breast cancer to be a complex disease demonstrating heterogeneity at clinical and histopathological levels, breast cancer in the Indian population could be biologically dhistology and receptor status characterization ifferent from those of the west. We attempt to study the clinical and pathological aspects of breast cancer and its correlation with biomolecular subtyping with comparison to the western population in order to find a pattern of differences. All patients diagnosed and treated in the Department of Surgical Oncology, King George Medical University, Lucknow, UP, from the period of August 2014 to August 2016 are included. Clinical and histopathological data was recorded. A total of 355 patients were analyzed. Average age of patients with disease was 45.3 years. The premenopausal group consists of 52% of patients. Mostly patients presented in locally advanced stage. Triple-negative disease was associated with higher grade of disease (p < 0.0001) and higher rates of lymphovascular invasion (p = 0.040), pericapsular invasion (p = 0.005), and extranodal spread of disease (p < 0.001).This subgroup was significantly higher in premenopausal patients (p = .016). Disease-free survival was lower in triple-negative group. As compared to the western population, the breast cancer in India presents in younger, premenopausal, multiparous, and breast feeding women. Molecular subgrouping reveals that about 60% of the patients are hormone negative. Forty-three percent of patients were triple negative. It appears to be that breast cancer in India is a different subset from the western world in having different molecular signatures that translate into distinct clinical and histopathological subgroup.

Keywords

Breast cancer Indian Biomolecular subtyping Triple negative 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    DeSantis C, Ma J, Bryan L, Jemal A (2014) Breast Cancer Statistics. CA Cancer J Clin 64(1):52–62.  https://doi.org/10.3322/caac.21203 Google Scholar
  2. 2.
    Surveillance, Epidemiology, and End Results (SEER) Program Populations (1969-2016) National Cancer Institute, DCCPS, Surveillance Research Program. www.seer.cancer.gov/popdata. Accessed December 2017
  3. 3.
    Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2013) GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC CancerBase no. 11 [internet]. International Agency for Research on Cancer, LyonGoogle Scholar
  4. 4.
    Onitilo AA, Engel JM, Greenlee RT, Mukesh BN (2009) Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res 7(1/2):4–13CrossRefGoogle Scholar
  5. 5.
    Manjunath S, Prabhu JS, Kaluve R, Correa M, Sridhar TS (2011) Estrogen receptor negative breast cancer in india: do we really have higher burden of this subtype? Indian J Surg Oncol 2(2):122–125CrossRefGoogle Scholar
  6. 6.
    Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE (2010) Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S. - a SEER analysis. BMC Cancer 10:191CrossRefGoogle Scholar
  7. 7.
    Kurian AW, Fish K, Shema SJ, Clarke CA et al (2010) Lifetime risks of specific breast cancer subtypes among women in four racial/ethnic groups. Breast Cancer Res 12:R99CrossRefGoogle Scholar
  8. 8.
    Munjal K, Ambaye A, Evans MF, Mitchell J, Nandedkar S, Cooper K (2010) Immunohistochemical analysis of ER, PR, Her2 and CK5/6 in infiltrative breast carcinomas in Indian patients. Asian Pac J Cancer Prev 10:773–778Google Scholar
  9. 9.
    Shet T, Agrawal A, Nadkarni M, Palkar M, Havaldar R, Parmar V, Badwe R, Chinoy RF (2009) Hormone receptors over the last 8 years in cancer referral center in India What was and what is. Indian J Pathol Microbiol 52(2):171–174CrossRefGoogle Scholar
  10. 10.
    Su Y, Zheng Y, Zheng W, Gu K, Chen Z, Li G, Cai Q, Lu W, Shu XO (2011) Distinct distribution and prognostic significance of molecular subtypes of breast cancer in Chinese women: a population-based cohort study. BMC Cancer 11:292CrossRefGoogle Scholar
  11. 11.
    Ambroise M, Ghosh M, Mallikarjuna VS, Kurian A (2011) Immunohistochemical profile of breast cancer patients at a tertiary care hospital in South India. Asian Pac J Cancer Prev 12:625–629PubMedGoogle Scholar
  12. 12.
    Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, Lickley LA, Rawlinson E, Sun P, Steven A (2007) Narod triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13:4429–4434 Published online August 1, 2007CrossRefGoogle Scholar
  13. 13.
    Rakha EA, El-Sayed ME, Green AR, Lee AH, Robertson JF, Ellis IO (2007) Prognostic markers in triple-negative breast cancer. Cancer 109(1):25–32CrossRefGoogle Scholar
  14. 14.
    Dunnwald LK, Rossing MA, Li CI (2007) Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res 9:R6.  https://doi.org/10.1186/bcr1639 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Cheang MC, Voduc D, Bajdik C, Leung S, McKinney S, Chia SK, Perou CM, Nielson TO (2008) Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clin Cancer Res 14:1368–1376 Published online March 3, 2008CrossRefGoogle Scholar

Copyright information

© Association of Surgeons of India 2018

Authors and Affiliations

  1. 1.King George Medical UniversityLucknowIndia

Personalised recommendations