Skip to main content
Log in

Profile of Breast Cancer in a Group of Women in a Developing Country in South Asia: Is There a Difference?

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Breast cancer is the commonest cancer among Sri Lankan women. The aim of this study was to document the breast cancer profile of a group of Sri Lankan women and compare it with regional data. Patient-tumor characteristics and predicted prognosis are compared with the immune profile.

Methods

A total of 814 Sri Lankan women with breast cancer were studied, with their information retrieved from patient records. Tumor type and grade were reassessed on routine tissue sections. The Nottingham Prognostic Index (NPI) was calculated. Estrogen receptors (ER) and human epidermal receptor 2 (HER2) were assessed using Dako antibodies. Strong nuclear staining for ER in >10% of tumor cells and strong, complete cell membrane staining (3+) for HER2 were regarded as positive. An SPSS-16 software program and the chi-squared test were used for statistical analysis.

Results

The highest prevalence (32%) was in the 50- to 59-year age cohort (mean ± SD 51.88 ± 11.939 years). In all, 58% of the tumors measured between 2 and 5 cm. Most (52%) were moderately differentiated and were invasive ductal carcinomas (86.3%). Regional lymph node metastasis was present in 41% of the patients. ER was expressed in 31.7% and was more frequent in women >35 years (p < 0.024). HER2 was found in 14.5% of tumors. Its expression was lower in ER-positive tumors (p < 0.000). Well-differentiated tumors were frequently ER-positive (p < 0.000) and HER2-negative (p < 0.001). The NPI was better for ER-positive (p < 0.000) and HER2-negative tumors (p < 0.028).

Conclusions

The overall profile of breast cancer and immune characteristics of Sri Lankan women in this study was largely comparable to profiles documented elsewhere in the region despite the lower prevalence of ER.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Kelsey JL, Horn-Ross PL (1993) Breast cancer: magnitude of the problem and descriptive epidemiology. Epidemiol Rev 15:7–16

    PubMed  CAS  Google Scholar 

  2. Anonymous (2000) Cancer Registry 2000. Cancer Control Programme. Cancer Institute, Maharagama, Sri Lanka

  3. United Nations (2002) Department of Economic and Social Affairs Population Division. World Population Aging 1950–2050. United Nations Publications, New York

    Google Scholar 

  4. Fletcher CDM (2007) Diagnostic histopathology of tumours, 3rd edn. Churchill Livingstone, New York, pp 950–951

    Google Scholar 

  5. Malik IA (2002) Clinico-pathological features of breast cancer in Pakistan. J Pak Med Assoc 52:100–104

    PubMed  CAS  Google Scholar 

  6. Thike AA, Chng MJ, Fook-Chong S et al (2001) Immunohistochemical expression of hormone receptors in invasive breast carcinoma: correlation of results of H-scores with pathological parameters. Pathology 33:21–25

    Article  PubMed  CAS  Google Scholar 

  7. Lertsanguansinchai P, Chottetanaprasith T, Chatamra K et al (2002) Estrogen and progesterone receptors status in Thai female breast cancer patients: an analysis of 399 cases at King Chulalongkorn Memorial Hospital. J Med Assoc Thai 85:193–202

    Google Scholar 

  8. Greenall MJ (2000) Cancer of the breast. In: Morris PJ, Wood WC (eds) Oxford textbook of surgery, 2nd edn. Oxford University Press, Turin, pp 1191–1223

  9. Ellis IO, Galea M, Broughton N et al (1992) Pathological prognostic factors in breast cancer: relationship with survival in a large study with long term follow up. Histopathology 20:479–489

    PubMed  CAS  Google Scholar 

  10. Pinder SE, Ellis IO, Elston CW (1995) Prognostic factors in primary breast cancer. J Clin Pathol 48:981–983

    Article  PubMed  CAS  Google Scholar 

  11. Grann VR, Troxel AB, Zojwalla NJ et al (2005) Hormone receptor status and survival in a population-based cohort of patients with breast carcinoma. Cancer 103:2241–2251

    Article  PubMed  CAS  Google Scholar 

  12. Allred DC, Harvey JM, Berardo M et al (1998) Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 11:155–168

    PubMed  CAS  Google Scholar 

  13. Burstein HJ (2005) The distinctive nature of HER2 positive breast cancers. N Engl J Med 353:1652–1654

    Article  PubMed  CAS  Google Scholar 

  14. Ariga R, Zarif A, Korasick J et al (2005) Correlation of HER-2 neu gene amplification with other prognostic and predictive factors in female breast carcinoma. Breast J 11:278–280

    Article  PubMed  CAS  Google Scholar 

  15. Slamon DJ, Godolphin W, Jones LA et al (1989) Studies of the HER-2 neu proto-oncogene in human breast and ovarian cancer. Science 244:707–712

    Article  PubMed  CAS  Google Scholar 

  16. Desai SB, Moonim MT, Gill AK et al (2000) Hormone receptor status of breast cancer in India: a study of 798 tumours. Breast 9:267–270

    Article  PubMed  CAS  Google Scholar 

  17. Aryandono T, Harijadi, Ghozali A (2000) Corelation of clinical, pathological status, hormone receptor status and c-erb-b-2 oncoprotein in breast cancer patients. Gan To Kagaku Ryoho 27:600–606

  18. Navani S, Bhaduri AS (2005) High incidence of oestrogen receptor negative progesterone receptor positive phenotype in Indian breast cancer: fact or fiction? Indian J Pathol Microbiol 48:199–201

    PubMed  Google Scholar 

  19. Ross JR, Linette GP, Stec J et al (2004) Breast cancer biomarkers and molecular medicine. II. Expert Rev Mol Diagn 4:169–188

    Article  PubMed  CAS  Google Scholar 

  20. Redkar AA, Kabre SS, Mittra I (1992) Estrogen and progesterone receptors measurement in breast cancer with enzyme-immunoassay and correlation with other prognostic factors. Indian J Med Res 96:1–8

    PubMed  CAS  Google Scholar 

  21. Fatima S, Faridi N, Gill S (2005) Breast cancer: steroid receptors and other prognostic indicators. J Coll Physicians Surg Pak 15:230–233

    PubMed  Google Scholar 

Download references

Acknowledgment

The initial part of this study was funded by National Science Foundation Sri Lanka grant RG/97/M4.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Menaka D. S. Lokuhetty.

Additional information

The initial findings of this study have been presented at several scientific sessions/meetings: Annual Academic Sessions of College of Surgeons of Sri Lanka and the 2nd International Conference of the SAARC Surgical Care Society, August 2003, Kandy, Sri Lanka; 114th Annual Academic Sessions of the Sri Lanka Medical Association, March 2001; 39th World Congress of Surgery of the International Society of Surgery, August 2001, Brussels, Belgium; 115th Annual Academic Sessions of the Sri Lanka Medical Association, March 2002.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lokuhetty, M.D.S., Ranaweera, G.G., Wijeratne, M.D.M. et al. Profile of Breast Cancer in a Group of Women in a Developing Country in South Asia: Is There a Difference?. World J Surg 33, 455–459 (2009). https://doi.org/10.1007/s00268-008-9860-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-008-9860-x

Keywords

Navigation