Trends in clinico-pathological and risk factor profile of breast cancer; 10-year experience at a single center in Sri Lanka

Abstract

Background The incidence of breast cancer in Sri Lanka is increasing on par with the rest of Asia. Lifestyle changes increasing the prevalence of risk factors of breast cancer among Asian women are claimed to be one of the reasons for this trend. Aim To analyze the clinico-pathological and risk factor profile of a cohort of breast cancer patients to detect any change in the patterns, over time. Method All breast cancer patients whose hormone receptor and Her2 status were evaluated in our laboratory from 2006 to 2015 were included. Clinicopathological data was retrieved from the laboratory records. A pre tested interviewer administered questionnaire was used to collect data on risk factors. Results A total of 1371 patients were included. There was a significant change in trend in the age (p=0.001) with an upturn in the breast cancer patients over 60 years of age. A significant change in trend was also observed in TNM stage (p=0.002), tumour size, Nottingham grade and lympho-vascular invasion (p<0.001). Hormone receptor expression showed an upward trend towards the latter part of the decade (p<0.001). A parallel decline in the triple negative cancers was also noted (p<0.001). However, Her2 status, lymph node metastases and lymph node stage did not show a change in trend. The only risk factor with a significant change was family history of breast cancer which had a downward trend (p=0.002). Conclusion This study describes an upward shift in the hormone receptor expression which can be attributed to the upward trend in the percentage of patients of >60 years. No significant change in trend in the risk factor profile was observed except for the downward trend in family history of breast cancer.