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Open Access 01-12-2019 | Breast Cancer | Research article

Pathological profiles and clinical management challenges of breast cancer emerging in young women in Indonesia: a hospital-based study

Authors: Sumadi Lukman Anwar, Clarista Adelia Raharjo, Rahma Herviastuti, Ery Kus Dwianingsih, Didik Setyoheriyanto, Widya Surya Avanti, Lina Choridah, Wirsma Arif Harahap, Darwito, Teguh Aryandono, Wahyu Wulaningsih

Published in: BMC Women's Health | Issue 1/2019

Abstract

Background

Breast cancer diagnosed at a young age is often associated with aggressive biology, advanced stage, and unfavorable prognosis. The median age of breast cancer diagnosis in Indonesia is younger (48 vs. 68 years-old in Europe) with a relatively higher proportion of patients younger than 40 years old. Although prognosis and outcome of young breast cancer are well studied in developed nations, research evaluating biological characteristics, delivered treatment, and clinical outcomes is very limited in Indonesia.

Methods

We analyzed all breast cancer patients who underwent surgery at Dr. Sardjito Hospital, Indonesia, in 2012–2017. Details of pathology profiles, treatment administrated, and outcomes, as well as reproductive factors among patients younger than 40 years old, were collected and analyzed. Kaplan-Meier curve was used to assess conditional survival based on baseline characteristics.

Results

From the total of 1259 breast cancer patients (median age 51 years), 144 (11.4%) were younger than 40 years old (median age 37 years). Of these young patients, 19 (13.2%) were bilateral and 92 (64%) were diagnosed in advanced stages (stages IIIA-C and IV). Median tumor diameter was 5.5 cm and nodal infiltration was present in 73%. Distant metastasis was found in 16% at the time of diagnosis. Moderate and poor differentiation of tumor were 20.8 and 78.5%, respectively, and lymphovascular invasion was found in 90.3%. Around 40% were hormone receptor-positive, 30.6% human epidermal growth factor receptor 2 positive, and 38.2% triple negative. Patients underwent radical surgery in 121 cases (84%) and breast conserving surgery in 7 cases (4.9%). Adjuvant chemotherapy was administrated in 68% and hormonal therapy in 34%. Progression-free survival was significantly shorter in patients with advanced stage, skin and chest wall involvement (T4), positive lymph node infiltration, positive hormonal receptor, and triple negative subtype (log-rank Mantel-Cox tests, p < 0.05).

Conclusion

We found a high frequency of young breast cancer with biologically more aggressive tumors, late diagnosis, frequent relapse, and poor prognosis. Further actions to improve clinical management and meet psychosocial needs in young breast cancer patients are warranted.

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Title: Pathological profiles and clinical management challenges of breast cancer emerging in young women in Indonesia: a hospital-based study
Authors: Sumadi Lukman Anwar
Clarista Adelia Raharjo
Rahma Herviastuti
Ery Kus Dwianingsih
Didik Setyoheriyanto
Widya Surya Avanti
Lina Choridah
Wirsma Arif Harahap
Darwito
Teguh Aryandono
Wahyu Wulaningsih
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Breast Cancer
Breast Cancer
Cytostatic Therapy
Published in: BMC Women's Health / Issue 1/2019
Electronic ISSN: 1472-6874
DOI: https://doi.org/10.1186/s12905-019-0724-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pathological profiles and clinical management challenges of breast cancer emerging in young women in Indonesia: a hospital-based study

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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