Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer
PURPOSE Breast cancer is the most common cancer in women in India, with higher incidence rates of aggressive subtypes, such as triple-negative breast cancer (TNBC). METHODS A systematic review was performed to compute pooled prevalence rates of TNBC among patients with breast cancer, and clinical fe...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
American Society of Clinical Oncology
2020-11-01
|
| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.20.00054 |
| _version_ | 1818357818638467072 |
|---|---|
| author | Apurv Kulkarni Devaki A. Kelkar Nidhi Parikh Lingadahalli S. Shashidhara Chaitanyanand B. Koppiker Madhura Kulkarni |
| author_facet | Apurv Kulkarni Devaki A. Kelkar Nidhi Parikh Lingadahalli S. Shashidhara Chaitanyanand B. Koppiker Madhura Kulkarni |
| author_sort | Apurv Kulkarni |
| collection | DOAJ |
| description | PURPOSE Breast cancer is the most common cancer in women in India, with higher incidence rates of aggressive subtypes, such as triple-negative breast cancer (TNBC). METHODS A systematic review was performed to compute pooled prevalence rates of TNBC among patients with breast cancer, and clinical features at presentation were systematically compared with non-TNBC in an Indian cohort of 20,000 patients. RESULTS Combined prevalence of TNBC among patients with breast cancer was found to be on the higher side (27%; 95% CI, 24% to 31%). We found that the estrogen receptor (ER) expression cutoff used to determine ER positivity had an influence on the pooled prevalence and ranged from 30% (ER/progesterone receptor [PR] cut ff at 1%) to 24% (ER/PR cutoff at 10%). Odds for TNBC to present in the younger age-group were significantly higher (pooled odds ratio [OR], 1.35; 95% CI, 1.08 to 1.69), with a significantly younger mean age of incidence (weighted mean difference, −2.75; 95% CI, −3.59 to −1.92). TNBC showed a significantly higher odds of presenting with high grade (pooled OR, 2.57; 95% CI, 2.12 to 3.12) and lymph node positivity (pooled OR, 1.39; 95% CI, 1.21 to 1.60) than non-TNBC. CONCLUSION Systematic review and meta-analysis of 34 studies revealed a high degree of heterogeneity in prevalence of TNBC within Indian patients with breast cancer, yet pooled prevalence of TNBC is high in India. High proportions of patients with TNBC present with aggressive features, such as high grade and lymph node positivity, compared with patients without TNBC. We emphasize the need for standardized methods for accurate diagnosis in countries like India. |
| first_indexed | 2024-12-13T20:19:09Z |
| format | Article |
| id | doaj.art-792595dcfd964e0ba9e1f77c4891d56f |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-12-13T20:19:09Z |
| publishDate | 2020-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-792595dcfd964e0ba9e1f77c4891d56f2022-12-21T23:32:44ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412020-11-0161052106210.1200/GO.20.00054Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast CancerApurv Kulkarni0Devaki A. Kelkar1Nidhi Parikh2Lingadahalli S. Shashidhara3Chaitanyanand B. Koppiker4Madhura Kulkarni5Indian Institute of Science Education and Research, Pune, IndiaPrashanti Cancer Care Mission, Pune, IndiaIndian Institute of Science Education and Research, Pune, IndiaIndian Institute of Science Education and Research, Pune, IndiaPrashanti Cancer Care Mission, Pune, IndiaPrashanti Cancer Care Mission, Pune, IndiaPURPOSE Breast cancer is the most common cancer in women in India, with higher incidence rates of aggressive subtypes, such as triple-negative breast cancer (TNBC). METHODS A systematic review was performed to compute pooled prevalence rates of TNBC among patients with breast cancer, and clinical features at presentation were systematically compared with non-TNBC in an Indian cohort of 20,000 patients. RESULTS Combined prevalence of TNBC among patients with breast cancer was found to be on the higher side (27%; 95% CI, 24% to 31%). We found that the estrogen receptor (ER) expression cutoff used to determine ER positivity had an influence on the pooled prevalence and ranged from 30% (ER/progesterone receptor [PR] cut ff at 1%) to 24% (ER/PR cutoff at 10%). Odds for TNBC to present in the younger age-group were significantly higher (pooled odds ratio [OR], 1.35; 95% CI, 1.08 to 1.69), with a significantly younger mean age of incidence (weighted mean difference, −2.75; 95% CI, −3.59 to −1.92). TNBC showed a significantly higher odds of presenting with high grade (pooled OR, 2.57; 95% CI, 2.12 to 3.12) and lymph node positivity (pooled OR, 1.39; 95% CI, 1.21 to 1.60) than non-TNBC. CONCLUSION Systematic review and meta-analysis of 34 studies revealed a high degree of heterogeneity in prevalence of TNBC within Indian patients with breast cancer, yet pooled prevalence of TNBC is high in India. High proportions of patients with TNBC present with aggressive features, such as high grade and lymph node positivity, compared with patients without TNBC. We emphasize the need for standardized methods for accurate diagnosis in countries like India.https://ascopubs.org/doi/10.1200/GO.20.00054 |
| spellingShingle | Apurv Kulkarni Devaki A. Kelkar Nidhi Parikh Lingadahalli S. Shashidhara Chaitanyanand B. Koppiker Madhura Kulkarni Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer JCO Global Oncology |
| title | Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer |
| title_full | Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer |
| title_fullStr | Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer |
| title_full_unstemmed | Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer |
| title_short | Meta-Analysis of Prevalence of Triple-Negative Breast Cancer and Its Clinical Features at Incidence in Indian Patients With Breast Cancer |
| title_sort | meta analysis of prevalence of triple negative breast cancer and its clinical features at incidence in indian patients with breast cancer |
| url | https://ascopubs.org/doi/10.1200/GO.20.00054 |
| work_keys_str_mv | AT apurvkulkarni metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer AT devakiakelkar metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer AT nidhiparikh metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer AT lingadahallisshashidhara metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer AT chaitanyanandbkoppiker metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer AT madhurakulkarni metaanalysisofprevalenceoftriplenegativebreastcanceranditsclinicalfeaturesatincidenceinindianpatientswithbreastcancer |