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Open Access Highly Accessed Research article

A Nation-Wide multicenter 10-year (1999-2008) retrospective clinical epidemiological study of female breast cancer in china

Jing Li1, Bao-Ning Zhang2, Jin-Hu Fan1, Yi Pang111, Pin Zhang3, Shu-Lian Wang4, Shan Zheng5, Bin Zhang6, Hong-Jian Yang7, Xiao-Ming Xie8, Zhong-Hua Tang9, Hui Li10, Jia-Yuan Li11, Jian-Jun He12 and You-Lin Qiao1*

Author Affiliations

1 Dept. of Cancer Epidemiology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China

2 Center of Breast Disease, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China

3 Dept. of Medical Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China

4 Dept. of Radiation Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China

5 Dept. of Pathology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, 17 South Panjiayuan Lane, Beijing 100021, China

6 Dept. of Breast Surgery, Liaoning Cancer Hospital, No. 44 Xiaoyanhe Road, Dadong District, Shenyang 110042, China

7 Dept. of Breast Surgery, Zhejiang Cancer Hospital, No. 38 Banshanqiao Guanji Road, Hangzhou 310022, China

8 Dept. of Breast Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng East, Gungzhou 510060, China

9 Dept. of Breast-thyroid Surgery, Xiangya Sencod Hospital, Central South University, No. 139 Renminzhonglu, Changsha 410011, China

10 Dept. of Breast Surgery, the Second People's Hospital of Sichuan Province, Chengdu 610041, China

11 Dept. of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan 610041, China

12 Dept. of Oncosurgery, the First Affiliated Hospital of Medical College, Xi'an JiaoTong University, 277 Yanta West Road, Xi'an 710061, China

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BMC Cancer 2011, 11:364  doi:10.1186/1471-2407-11-364

Published: 22 August 2011

Abstract

Background

According to the very limited cancer registry, incidence and mortality rates for female breast cancer in China are regarded to be increasing especially in the metropolitan areas. Representative data on the breast cancer profile of Chinese women and its time trend over years are relatively rare. The aims of the current study are to illustrate the breast cancer profile of Chinese women in time span and to explore the current treatment approaches to female breast cancer.

Methods

This was a hospital-based nation-wide and multi-center retrospective study of female primary breast cancer cases. China was divided into 7 regions according to the geographic distribution; from each region, one tertiary hospital was selected. With the exception of January and February, one month was randomly selected to represent each year from year 1999 to 2008 at every hospital. All inpatient cases within the selected month were reviewed and related information was collected based on the designed case report form (CRF). The Cancer Hospital/Institute, Chinese Academy of Medical Sciences (CICAMS) was the leading hospital in this study.

Results

Four-thousand two-hundred and eleven cases were randomly selected from the total pool of 45,200 patients and were included in the analysis. The mean age at diagnosis was 48.7 years (s.d. = 10.5 yrs) and breast cancer peaked in age group 40-49 yrs (38.6%). The most common subtype was infiltrating ductal carcinoma (86.5%). Clinical stage I & II accounted for 60.6% of 4,211 patients. Three-thousand five-hundred and thirty-four cases had estrogen receptor (ER) and progestin receptor (PR) tests, among them, 47.9% were positive for both. Two-thousand eight-hundred and forty-nine cases had human epidermal growth factor receptor 2(HER-2) tests, 25.8% of them were HER-2 positive. Among all treatment options, surgery (96.9% (4,078/4,211)) was predominant, followed by chemotherapy (81.4% (3,428/4,211). Much less patients underwent radiotherapy (22.6% (952/4,211)) and endocrine therapy (38.0% (1,599/4,211)).

Conclusions

The younger age of breast cancer onset among Chinese women and more advanced tumor stages pose a great challenge. Adjuvant therapy, especially radiotherapy and endocrine therapy are of great unmet needs.