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Risk factors and natural history of breast cancer in younger Chinese women

World Journal of Clinical Oncology 2014年第5期5卷 1097-1106页

作者： Winnie Yeo Hang-Mei Lee Amy Chan Emily YY Chan Miranda CM Chan Keeng-Wai Chan Sharon WW Chan foon-Yiu Cheung Polly SY Cheung Peter HK Choi Josette SY Chor william wl foo Wing-Hong Kwan Stephen CK Law Lawrence PK Li Janice WH Tsang Yuk Tung Lorna LS Wong Ting-Ting Wong Chun-Chung Yau Tsz-Kok Yau Benny CY Zee Department of Clinical Oncology Chinese University of Hong Kong Prince of Wales Hospital Hong Kong Breast Cancer Foundation Jockey Club School of Public Health and Primary Care Chinese University of Hong Kong Department of Surgery Kwong Wah Hospital Diagnostix Pathology Laboratories Ltd Canossa Hospital Kowloon East Cluster Breast Centre Department of Surgery United Christian Hospital Department of Clinical Oncology Pamela Youde Nethersole Eastern Hospital Private Clinical Oncologist Radiotherapy and Oncology Centre Hong Kong Baptist Hospital Comprehensive Oncology Centre Hong Kong Sanatorium and Hospital Hong Kong Adventist Oncology Center Hong Kong Adventist Hospital Department of Clinical Oncology University of Hong Kong Department of Clinical Oncology Tuen Mun Hospital Private Surgeon Department of Clinical Oncology Princess Margaret Hospital

AIM: To investigate the age differences in the risk factors, clinicopathological characteristics and patterns of treatment of female breast cancer patients. METHODS: Seven thousand one hundred and fiftytwo women with primary breast cancer from the Hong Kong Breast Cancer Registry were recruited after receiving patients' consent, they were asked to complete standardized questionnaires which captured their sociodemographic characteristics and risk factors associated with breast cancer development. Among them, clinicopathological data and patterns of treatment were further collected from medical records of 5523 patients with invasive breast cancers. Patients were divided into two groups according to the age at diagnosis: younger(< 40 years old) vs older patients(≥ 40 years old) for subsequent analyses.RESULTS: Analysis on the sociodemographic characteristics and exposure to risk factors were performed on 7152 women with primary breast cancer and the results revealed that younger patients were more likely to have unhealthy lifestyles; these include a lack of exercise(85.4% vs 73.2%, P < 0.001), having high stress in life(46.1% vs 35.5%, P < 0.001), having dairy/meat-rich diets(20.2% vs 12.9%, P < 0.001),having alcohol drinking habit(7.7% vs 5.2%, P = 0.002). Younger patients were also more likely to have hormone-related risk factors including nulliparity(43.3% vs 17.8%, P < 0.001) and an early age at menarche(20.7% vs 13.2%, P < 0.001). Analyses on clinicopathological characteristics and patterns of treatment were performed on 5523 women diagnosed with invasive breast cancer. The invasive tumours in younger patients showed more aggressive pathological features such as having a higher percentage of grade 3 histology(45.7% vs 36.5%, P < 0.001), having a higher proportion of tumours with lymphovascular invasion(39.6% vs 33.2%, P = 0.003), and having multifocal disease(15.7% vs 10.3%, P < 0.001); they received different patterns of treatment than their older counterparts.CONCLUSION: Younger patients in Hong Kong are more

关键词： Hong Kong Breast Cancer Registry Breast cancer Younger Chinese women Sociodemographic characteristics Risk factors Clinicopathological characteristics Breast cancer treatment

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