Kingdom of Saudi Arabia Ministry of Health Agency of Public Health Assistant Agency for Preventive Health Field Epidemiology Training Program Breast cancer in women aged 40 and below reported to Sultan Qaboos Cancer Care Comprehensive Center: 20 Years Ret

Abstract

Background: Breast cancer is considered a public health concern worldwide. In 2020, 11·7% of all cancers diagnosed in the world were female breast cancer, making it the most common cancer reported around the globe. Breast cancer comprises 22·36% of all diagnosed cancers among Omani women. Breast cancer in young women has not been studied in Oman, for which, this study was conducted. Also, to understand the histological and molecular pattern of BC in this age group, as well as to estimate the overall (OS) survival of these patients.
Methods: We conducted a retrospective cohort study. Electronic data was collected from women aged 40 and below treated at Sultan Qaboos Cancer Care Comprehensive Center (SQCCCRC), from 2002-2022. Secondary data for socio-demographics, family history of BC, BC histological subtypes, immunohistochemistry (PR, ER, and HER2), and TNM staging were collected. SPSS was used to analyze the data. Appropriate statistical tests were used for descriptive and inferential analysis. The Kaplan-Meier estimator and log-rank test were used for the survival analysis. Differences were considered statistically significant at p-value < 0·05.
Results: A total of 418 patients were included in the study. The reported cases' mean age at the time of diagnosis was (34·7 ±4·3 years), with a mean BMI of (28· 47±6·6). 16·7% of patients had a positive family history of BC. Out of all cases, 84·7% of cases were ductal, while 3·3% were lobular. On diagnosis, the majority of patients (39·1%) were in the T2 stage, while 14·1% were in the Metastatic stage, and 37·6% had axillary lymph node metastases. Whereas, 68 (16·3%) were in the early stage, and 213(51%) of the patients reported a locally advanced stage of BC. Positive PR, ER, and HER2 immunostaining were 61·6%, 70%, and 42·2% respectively. Early-stage (T1,2 and N0, M 0) patients had 89% five-year overall survival (OS), while locally advanced (T0-1-2, N1-2-3, M0) patients had 80% five-year OS, and metastatic (T0-1-2-3, N1-2, M1) patients had 40% five-year OS (p=0·001).

Conclusion: Our study showed that BC has the same pathological characteristics as the neighboring countries but it differs from other developed countries, and this requires further study. Reviewing the screening program and maintaining a well-organized cancer registry would help in dealing with breast cancer more promptly.