Association between Triple-Negative Breast Cancer and Socioeconomic and Cultural Factors in Southeast Anatolia: A Single-Center Experience

Year 2022, Volume: 12 Issue: 6, 823 - 826, 30.11.2022

Hilal Alkış , Abdurahman Kuzhan

https://doi.org/10.16899/jcm.1129119

Abstract

Objective: Triple-negative breast cancers (TNBCs) are associated with younger age, advanced stage at diagnosis, ethnicity, lower socioeconomic status (SES), and poor prognosis. The aim of the study was to investigate clinicopathologic features of TNBC patients living in Southeastern Anatolia, and the association between socioeconomic and cultural factors and TNBC.
Material and Methods: A total of 875 women were included in the study. The effects of socioeconomic factors and cultural factors on clinicopathologic features of TNBC patients were evaluated. The SES of the patients was categorized as lower and higher according to educational and health insurance status, and household income. Patients’ age at diagnosis, living area (rural or urban), SES, and ethnicity (Arabic, Armenian, Kurdish, and Turkish) were recorded.
Results: Median age was 47 (20-85) and 10% (n=87) of the patients were diagnosed TNBC. TNBC rates were higher in patients ≤40 years. Younger age, lower SES, and Arabic and Kurdish ethnicities were associated with higher rates of TNBC.
Conclusion: Although the majority of the breast cancer patients in our region were premenopausal, the rate of TNBC among them was found to be lower than the general rate of western countries. Socioeconomic and cultural factors may affect tumor biology and prognosis of the disease in patients with TNBC. In our study, younger age, lower SES, and ethnicity were found to be associated with higher rates of TNBC and worse prognosis.

Keywords

triple-negative breast cancer, socioeconomic factors, prognosis

Güneydoğu Anadolu’da Triple Negatif Meme Kanseri ile Sosyoekonomik ve Kültürel Faktörler Arasındaki İlişki: Tek Merkez Deneyimi

Abstract

Amaç: Triple negatif meme kanseri (TNMK) genç yaş, tanı anında ileri evre hastalık, etnik köken, düşük sosyoekonomik statü (SES) ve kötü prognozla ilişkilidir. Bu çalışmanın amacı Güneydoğu Anadolu’da yaşayan triple negatif meme kanserli hastaların klinikopatolojik özelliklerinin yanı sıra TNMK ile sosyoekonomik ve kültürel faktörler arasındaki ilişkiyi araştırmaktır.
Gereç ve Yöntemler: Toplam 875 hasta çalışmaya dâhil edildi. Sosyoekonomik ve kültürel faktörlerin TNMK’nin klinikopatolojik özellikleri üzerine olan etkisi değerlendirildi. Hastalar SES, eğitim düzeyi, aylık gelirleri ve sağlık güvencesi durumuna göre düşük ve yüksek olmak üzere ikiye ayrıldı. Hastaların tanı anındaki yaşı, yaşadıkları bölge (kırsal veya kentsel), SES ve etnik kökenleri (Arap, Ermeni, Kürt, Türk) kaydedildi.
Bulgular: Medyan hasta yaşı 47 (20-85) olarak bulundu. Hastaların %10’unda (n=87) TNMK tanısı mevcuttu. TNMK oranları 40 yaş ve altındaki hastalarda daha fazlaydı. Genç yaş, düşük SES ve Arap ile Kürt etnik kökenlilerde TNMK oranları daha yüksek bulundu.
Sonuç: Bölgemizdeki hastaların çoğunluğu premenopozal olmasına rağmen TNMK oranları batılı ülkelerdeki oranlardan daha düşük bulunmuştur. Sosyoekonomik ve kültürel faktörler TNMK olan hastalarda tümör biyolojisini etkileyebilmektedir. Genç yaş, düşük SES ve etnik kökenin daha yüksek TNMK oranları ve daha kötü prognozla ilişkili olduğu bulunmuştur.

Keywords

Triple negatif meme kanseri, sosyoekonomik faktörler, prognoz

References

• Yin L, Duan JJ, Bian XW, Yu SC. Triple-negative breast cancer molecular subtyping and treatment progress. Breast Cancer Res. 2020;22(1):61.
• Scott LC, Mobley LR, Kuo TM, Il'yasova D. Update on triple-negative breast cancer disparities for the United States: A population-based study from the United States Cancer Statistics database, 2010 through 2014. Cancer. 2019;125(19):3412-7.
• Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer. 2007;109(9):1721-8.
• Prakash O, Hossain F, Danos D, Lassak A, Scribner R, Miele L. Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors. Front Public Health. 2020;8:576964.
• Kuzhan A, Adli M. The Effect of Socio-Economic-Cultural Factors on Breast Cancer. J Breast Health. 2015;11(1):17-21.
• Tzikas AK, Nemes S, Linderholm BK. A comparison between young and old patients with triple-negative breast cancer: biology, survival and metastatic patterns. Breast Cancer Res Treat. 2020;182(3):643-54.
• Shoemaker ML, White MC, Wu M, Weir HK, Romieu I. Differences in breast cancer incidence among young women aged 20-49 years by stage and tumor characteristics, age, race, and ethnicity, 2004-2013. Breast Cancer Res Treat. 2018;169(3):595-606.
• Yildiz B, Fidan E, Ozdemir F, Sezen O, Kavgaci H, Aydin F. Clinicopathological Characteristics of Triple-negative Breast Cancers in the Northeast Region of Turkey. Balkan Med J. 2014;31(2):126-31.
• Budakoglu B, Altundag K, Aksoy S, Kaplan MA, Ozdemir NY, Berk V, et al. Outcome of 561 non-metastatic triple negative breast cancer patients: multi-center experience from Turkey. J BUON. 2014;19(4):872-8.
• Aksoy S, Dizdar O, Harputluoglu H, Altundag K. Demographic, clinical, and pathological characteristics of Turkish triple-negative breast cancer patients: single center experience. Ann Oncol. 2007;18(11):1904-6.
• Coughlin SS. Social determinants of breast cancer risk, stage, and survival. Breast Cancer Res Treat. 2019;177(3):537-48.
• Howard FM, Olopade OI. Epidemiology of Triple-Negative Breast Cancer: A Review. Cancer J. 2021;27(1):8-16.