Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2021; 9(19): 5046-5053
Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5046
Clinical and pathological features and risk factors for primary breast cancer patients
Ye-Yan Lei, Shuang Bai, Qing-Qing Chen, Xu-Jin Luo, Dong-Mei Li
Ye-Yan Lei, Shuang Bai, Qing-Qing Chen, Xu-Jin Luo, Dong-Mei Li, Department of Mammary Disease, Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, Zhuhai 519015, Guangdong Province, China
Author contributions: Li DM designed this retrospective study; Li DM and Lei YY wrote this paper; Lei YY, Bai S, Chen QQ, and Luo XJ were responsible for sorting the data.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Guangdong Provincial Hospital of Traditional Chinese Medicine (No. ZE2020-286-01).
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Mei Li, MM, Chief Physician, Department of Mammary Disease, Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, No. 53 Jingle Road, Zhuhai 519015, Guangdong Province, China. 896184582@qq.com
Received: January 21, 2021
Peer-review started: January 21, 2021
First decision: March 11, 2021
Revised: March 23, 2021
Accepted: April 25, 2021
Article in press: April 25, 2021
Published online: July 6, 2021
Processing time: 154 Days and 6.7 Hours
Abstract
BACKGROUND

Breast cancer is the most common malignancy in women all around the world. According to the latest statistics in 2018, there were more than 2.08 million new breast cancer cases all around the world and more than 620000 deaths; the proportion of breast cancer deaths in women with cancer is 15%. By studying age, clinicopathological characteristics and molecular classification, age at menarche, age at birth, number of births, number of miscarriages, lactation time, surgical history of benign breast lesions, history of gynecological diseases, and other factors, we retrospectively summarized and compared the disease history of patients with primary breast cancer and patients with benign thyroid tumors admitted to our hospital in the past 10 years to explore the clinicopathological characteristics and risk factors for primary breast cancer.

AIM

To investigate the clinical and pathological features and risk factors for primary breast cancer treated at our center in order to provide a reference for the prevention and treatment of breast cancer in the Zhuhai-Macao region.

METHODS

Through a retrospective case-control study, 149 patients with primary breast cancer diagnosed and treated at Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2013 to March 2020 were included as a case group, and 165 patients with benign breast tumors diagnosed and treated from January 2019 to March 2020 were included as a control group. The data collected included age, age at menarche, age at first birth, number of births, number of miscarriages, lactation time, history of surgery for benign breast lesions, history of familial malignant tumors, history of gynecological diseases, history of thyroid diseases, and the tumor characteristics of the patients in the case group including pathological diagnosis, pathological type, tumor size, lymph node metastasis, distant metastasis, stage, and molecular classification, among others. In the case group, the chi-square test was used to analyze the clinical and pathological features of patients in three age groups (< 40, 40-59, and ≥ 60 years). A multifactor logistic regression analysis was used to analyze correlations between the two groups.

RESULTS

Among 149 patients with primary breast cancer, the average age was 48.20 ± 12.06 years, and the proportion of patients at 40-59 years old was the highest, accounting for 61.8% of cases. The molecular type was mainly luminal B type, accounting for 69.2% of cases, and at the time of diagnosis, the tumor stage was mainly stage I/II, accounting for 62.4% of cases. There were no statistically significant differences in the distributions of tumor location, pathological type, tumor size, lymph node metastasis, stage, or molecular classification among the three age groups (< 40, 40-59, and ≥ 60 years) (P ≥ 0.05). The differences in the distribution of distant metastasis among the three age groups (< 40, 40-59, and ≥ 60 years) were statistically significant (P < 0.01). The differences in lactation time, history of familial malignant tumors, history of gynecological diseases, and history of thyroid diseases between the two groups were not statistically significant (P ≥ 0.05). The differences in age at disease diagnosis, age at menarche, and history of surgery for benign breast lesions were statistically significant (P < 0.01). The difference in age at first birth was also statistically significant (P < 0.05).

CONCLUSION

The highest incidence of breast cancer in the Zhuhai-Macao region is present among women aged 40-59 years. There is a larger proportion of stage I/II patients, and the luminal B type is the most common molecular subtype. Distant metastasis occurs mainly in the ≥ 60-year-old group at the first diagnosis; increased age, late age at menarche, and late age at first birth may be risk factors for primary breast cancer, and a history of surgery for benign breast lesions may be a protective factor for primary breast cancer.

Keywords: Primary breast cancer; Clinical pathological features; Risk factors; Retrospective study

Core Tip: This study found that distant metastasis is more common among elderly women aged ≥ 60 years; advanced age, late menarche, and late childbearing age are risk factors for the onset of primary breast cancer; and a surgical history of benign breast lesions is the primary protective factor against breast cancer.