Breast cancer in Iran: a survival analysis

Iranian Institute for Health Sciences Research, Tehran, Iran.
Asian Pacific journal of cancer prevention: APJCP (Impact Factor: 2.51). 11/2003; 5(2):223-5.
Source: PubMed

ABSTRACT A prospective study was undertaken to examine survival in Iranian breast cancer patients. One hundred and sixty-seven breast cancer patients diagnosed in 1997 were entered into the study and followed up for five years. The mean age of the patients at diagnosis was 47.2 (SD = 13.5), ranging from 24 to 81 years. A total of 39 patients were lost in the follow-up period, leaving 128 for analysis of data. Of these, 79 were alive and 49 were dead after five years. Most patients (61%) presented with advanced disease. Using life table analysis, the overall relative 5-year survival rate was found to be 62% (SE = 0.04). In addition, after adjustment for age at diagnosis, initial treatment (mastectomy, breast conserving surgery, and neo-adjuvant therapy), and disease stage, using Cox's regression model, it was found that receiving neo-adjuvant therapy as the initial treatment was an independent predictor of poorer survival (Hazard ratio = 4.56, 95% CI 2.20-9.44, P<0.0001). The other variables (older age and late stage disease), although associated with high hazards rates, were not significant. The study findings suggest that overall relative survival rate in Iranian breast cancer patients stands between western and eastern European countries and needs to be improved. It seems that early detection and better management using standard guidelines might contribute considerably to improvement of survival in women experiencing breast cancer.

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    • "This may be correspond with inclusion of higher number of patients in our study compared to cross sectional study of Ardabil (only patients of year 2003), as well as health promotion during the previous years. The other studies from Tehran have previously reported 5-year overall breast cancer survival rates of 60% (Mousavi et al., 2011) and 62% (Vahdaninia et al., 2004). These studies were conducted on records of patients during 1998-2001 and 1997 respectively. "
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    ABSTRACT: Background: Breast cancer is the most frequently occurring cancer among Iranian women; however limited studies have been conducted to address survival rates. Objective: The objective was to examine survival rates in Tabriz (Northwest of Iran) and compare with those of data reported from other cities and countries. Methods: Survival rates were calculated for one, three, five, seven and ten years for 271 breast cancer patients referred to one university clinic during 1997-2008. Results: Survival analysis demonstrated a lower survival rate compared to western countries. Conclusions: Survival rates for our patients are similar/better than other cities in Iran, but lower than certain European countries and the US. Further studies with a higher number of patients are now required.
    Asian Pacific journal of cancer prevention: APJCP 01/2013; 14(1):39-42. DOI:10.7314/APJCP.2013.14.1.39 · 2.51 Impact Factor
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    • "Despite significant individual effect of each parameter on RER, their effect became nonsignificant in multivariate analysis. Similar nonsignificant effect of tumour stage on breast cancer outcome, either recurrence or death, has been reported by two studies with smaller sample size conducted in Iran [22] [33]. "
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    ABSTRACT: Background. Tumour characteristics are the most important prognostic factors in breast cancer. Patient-related factors such as young age at diagnosis, obesity, and smoking behaviour may also modify disease outcome. Due to the absence of a unique definition for "young age breast cancer" and the resulting variation in disease management, findings on the association between young age and prognosis of breast cancer are controversial. Methods. This study included 1500 patients with a primary diagnosis of breast cancer in six Iranian hospitals from 5 provinces. We modelled the relative excess risk (RER) of breast cancer death to age at diagnosis and tumour characteristics. Results. Excess risks of death were observed for stage IV disease and poorly differentiated tumours: RER of 4.3 (95% CI: 1.05-17.65) and 3.4 (95% CI: 1.17-9.87), respectively. "Older" patients, particularly those aged 50 and over, presented more often with advanced and poorly differentiated tumours (P = 0.001). After adjustment for stage, histological grade, Her-2 expression, estrogen and progesterone receptors, and place of residency, breast cancer mortality was not significantly different across age groups. Conclusion. We conclude that there is no prognostic effect of age at diagnosis of breast cancer among breast cancer patients treated at cancer centres in different parts of Iran; young and relatively old women have similar risks of dying from breast cancer.
    11/2012; 2012:517976. DOI:10.1155/2012/517976
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    • "In the current study, the mean age of all the patients was 47.88±10.98 years, which is consistent with the reported results (Vahdaninia & Montazeri, 2004; Mousavi et al. ,2006), and proves that the onset of breast cancer in Iranian women is a decade earlier, when compared with those in Western countries (Harirchi et al., 2000; Mousavi et al., 2007b; Kolahdoozan et al., 2010). However, a significant correlation and an increasing trend of methylation were found for ER5 in elder patients than the younger ones. "
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    ABSTRACT: One decade early onset of the breast cancer in Iranian females was reported but the basis of the observed difference has remained unclear and difference in gene silencing by epigenetic processes is suggested. Hence, this study was sought to map the methylation status of ER gene CpG islands and its impact on clinicopathological factors of triple negative and non-triple negative ductal cell carcinoma of the breast in Iranian females. Surgically resected formalin-fixed paraffin-embedded breast tissues from sixty Iranian women with confirmed invasive ductal carcinoma were assessed by methylation-specific PCR using primer sets encompassing some of the 29 CpGs across the ER gene CpG island. The estrogen and progesterone receptors, Her-2 overexpression, and nuclear accumulation of P53 were examined using immunohistochemistry (IHC). Methylated ER3, ER4, and ER5 were found in 41.7, 11.3, and 43.3% of the samples, respectively. Significantly higher methylation of ER4 was found in the tumors with nuclear accumulation of P53, and significantly higher methylation of ER5 was found in patients with lymph node involvement and tumor with bigger size or higher grades. Furthermore, significantly higher rate of ER5 methylation was found in patients with Her-2+ tumors and in postmenopausal patients with ER-, PgR-, or ER-/PgR- tumors. However, no significant difference in ERs methylation status was found between triple negative and non-triple negative tumors in pre- and postmenopausal patients. Findings revealed that aberrant hypermethylation of ER-a gene frequently occur in Iranian women with invasive ductal cell carcinoma of the breast. However, methylation of different CpG islands produced a diverse impact on the prognosis of breast cancer, and ER5 was found to be the most frequently methylated region in the Iranian women, and could serve as a marker of poor prognosis.
    Asian Pacific journal of cancer prevention: APJCP 02/2012; 13(2):451-7. DOI:10.7314/APJCP.2012.13.2.451 · 2.51 Impact Factor
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