Abstract
Purpose
Women with breast cancer in Asian and Western countries are similar in many respects, but there are also differences, such as in the age at onset and the proportion of breast cancer occurring at younger ages. There is controversy as to whether these differences are due to inter-racial genetic differences or to environmental or other factors.
Methods
Using the Korean Breast Cancer Society’s large breast cancer registry, we investigated the causes of Koreans’ unique breast cancer characteristics by examining the changes in the incidence and proportion of young-onset breast cancer (YBC) in Korea over time. We analyzed data from 108,894 patients to compare characteristics between patients with YBC and non-YBC. For a subtype analysis, we analyzed data from 85,691 patients from 2000.
Results
Among the 108,894 patients, 17,877 (15.5%) had YBC. The tumors associated with YBC showed aggressive clinicopathologic features. The incidence of breast cancer in Korea has increased over time, and while both YBC and non-YBC increased each year, the increase in non-YBC was more pronounced; thus, the proportion of YBC has decreased over time. By 2020, it appears that the ratio of YBC in Korea will be similar to that in Western countries. The increase in YBC was mainly due to an increase in the luminal A subtype. The incidence of other YBC subtypes did not change over time.
Conclusions
Our data suggest that the current high proportion of YBC is probably not a unique feature of breast cancer in Asia but rather a transient phenomenon. Additionally, our results indirectly suggest that there were different causes for breast cancer in different age groups, suggesting the importance of using different approaches for different age groups to establish policies for preventing breast cancer.
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Data availability
Korean breast cancer registry (KBCR) which was used for this study is available with the permission of KBCS (the Korean Breast Cancer Society). I’ll provide the information on where data supporting the results reported in this article can be found including, where applicable, hyperlinks to publicly archived datasets analyzed or generated during the study.
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Acknowledgements
This article was supported by the Korean Breast Cancer Society. We are grateful to the statistical analysis of the Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center.
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The authors received no specific funding for this work.
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SKL, SJN, and SWK conceived and designed the study; the HGM, EKK, JYK, JW, SL, SSK, KBCS constructed the data; SKL and SJN analyzed the data; SKL, SJN, SWK, JHY, and JEL contributed reagents, materials, and/or analysis tools; SKL wrote the manuscript; and JHY, JEL, and the KBCS made other contributions.
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Ethical approval
Approval was granted by the Institutional Review Board of Samsung Medical Center (IRB File No. 2015-10-189). This study was performed in accordance with the Declaration of Helsinki.
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Lee, S.K., Kim, S.W., Yu, JH. et al. Is the high proportion of young age at breast cancer onset a unique feature of Asian breast cancer?. Breast Cancer Res Treat 173, 189–199 (2019). https://doi.org/10.1007/s10549-018-4947-z
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DOI: https://doi.org/10.1007/s10549-018-4947-z