Age and stage at diagnosis: a hospital series of 11 women with intellectual disability and breast carcinoma
1 Epidemiology and Biostatistics department (EA 2415) Oncodéfi project, University Institute for Clinical Research IURC Montpellier 1 University, 641, avenue du Doyen G. Giraud, 34093 Montpellier, France
2 Biostatistics Department, University of Strasbourg, Faculté de Médecine, 4 rue Kirschleger, 67085 Strasbourg, France
3 Medical Oncology, Institut Régional du Cancer de Montpellier (ICM), 208 rue des Apothiaires, Cedex 5, 34298 Montpellier, France
4 Obstetrics and Gynecology, Tulle hospital, Place Maschat, 19012 Tulle, France
5 CREAI-ORS Languedoc-Roussillon, Q.E. Tournezy 135 allée Sacha Guitry, B.P. 35567 34072 Montpellier, France
6 19220 Servière le Chateau, France
BMC Cancer 2014, 14:150 doi:10.1186/1471-2407-14-150Published: 4 March 2014
Breast cancer has been poorly studied in women with intellectual disability (ID), which makes designing a policy for screening the nearly 70 million women with ID in the world difficult. As no data is available in the literature, we evaluated breast cancer at diagnosis in women with ID.
Women with ID were searched retrospectively among all women treated for invasive breast cancer in a single hospital over 18 years. Age at diagnosis was compared among the whole group of women. Tumor size, lymph node involvement, SBR grade, TNM classification, and AJCC stage were compared to controls matched for age and period of diagnosis using conditional logistic regression.
Among 484 women with invasive breast cancer, 11 had ID. The mean age at diagnosis was 55.6 years in women with ID and 62.4 years in the other women. The mean tumor size in women with ID was 3.53 cm, compared to 1.80 cm in 44 random controls from among the 473 women without ID. Lymph node involvement was observed in 9 of the 11 women with ID compared to 12 of the controls (OR = 11.53, p = 0.002), and metastases were found in 3 of the 11 women with ID compared to 1 of the 44 controls (OR = 12.00, p = 0.031). The AJCC stage was higher in women with ID compared to controls (OR = 3.19, p = 0.010).
Women with ID presented at an earlier age with tumors of a higher AJCC stage than controls despite no significant differences in tumor grade and histological type. Thus, delayed diagnosis may be responsible for the differences between disabled and non-disabled women.