Dr.Vidhya.R, Dr. Kalaichelvi.K, Dr. Raja.G, Dr. Suresh Kumar.S
Breast cancer is the most common cancer among women in India and globally and the second leading cause of cancer mortality among females. Early stage breast cancer (>60%) is common in the western population with 72.7% being Luminal A sub type, 12.2% TNBC , 15-25% HER2 positive and 12% unknown status. In India, locally advanced breast cancer (LABC) constitutes 50 to 60% of the patients presenting for treatment and 6–25% have metastases with 51.2% being Luminal A and Luminal B subtype, 16.7% being HER2neu positive and 29.8% being triple negative. The 5 year disease free survival (DFS) rate is 70% and overall survival rate is 78% for early breast cancer.
Materials and methods:
All cases of breast cancer who were treated in the Department of Medical Oncology, RGGGH, Chennai from January 2014 to December 2016 were included in the analysis. Out of 736 patients, 612 patients with early and locally advanced breast cancer were analysed for baseline characteristics and survival.
Among 612 patients, 315 (42.8%) had early breast cancer and 297 (40.4%) had locally advanced breast cancer. Among them 30.7% were luminal subtype, 11.4% were triple positive, 13.7% were HER2 positive, 25.6% were triple negative and 17.5% had unknown status. The overall DFS and OS in early breast cancer was 57months and 58 months respectively and in locally advanced breast cancer was 51months and 52.5 months respectively.
Prevalence of TNBC in India is considerably higher compared with Western populations as suggested by various meta-analyses with Indians having 51.2% HR positive tumours, HER2 positive tumours in 16.7% and TNBC in 29.8%. In our study, 30.7% Luminal subtype, 11.4% were triple positive, 13.7% were HER2 positive, 25.6% were triple negative and 17.5% had unknown status. A study from India on patients with early breast cancer who had received multimodality treatment showed a 5 year DFS of 70% and OS of 78%. The overall DFS and OS in early breast cancer was 57months and 58 months respectively and locally advanced breast cancer was 51months and 52.5 months respectively
Conclusion: Breast cancer is the most common cancer and the leading cause of cancer mortality among females. In our study we found that most of our patients present with advanced disease and a higher percentage of TNBC and HER2 positive disease compared to western countries. Our patients default frequently, especially patients with advanced stage due to poor socioeconomic support. In our study we found that the survival of our patients was comparable to Indian studies, but was less than that seen among western patients.