Education level is a strong prognosticator in the subgroup aged more than 50 years regardless of the molecular subtype of breast cancer: A study based on the Nationwide Korean breast cancer registry database

  • Hwang, Ki-Tae
  • Noh, Woochul
  • Cho, Se-Heon
  • Yu, Jonghan
  • Park, Min Ho
  • ... Chung, Min Sung
  • 외 74명
Citations

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초록

Purpose This study investigated the role of the education level (EL) as a prognostic factor for breast cancer and analyzed the relationship between the EL and various confounding factors. Materials and Methods The data for 64,129 primary breast cancer patients from the Korean Breast Cancer Registry were analyzed. The EL was classified into two groups according to the education period; the high EL group (≥ 12 years) and low EL group (< 12 years). Survival analyses were performed with respect to the overall survival between the two groups. Results A high EL conferred a superior prognosis compared to a low EL in the subgroup aged > 50 years (hazard ratio, 0.626; 95% confidence interval [CI], 0.577 to 0.678) but not in the subgroup aged ≤ 50 years (hazard ratio, 0.941; 95% CI, 0.865 to 1.024). The EL was a significant independent factor in the subgroup aged > 50 years according to multivariate analyses. The high EL group showed more favorable clinicopathologic features and a higher proportion of patients in this group received lumpectomy, radiation therapy, and endocrine therapy. In the high EL group, a higher proportion of patients received chemotherapy in the subgroups with unfavorable clinicopathologic features. The EL was a significant prognosticator across all molecular subtypes of breast cancer. Conclusion The EL is a strong independent prognostic factor for breast cancer in the subgroup aged > 50 years regardless of the molecular subtype, but not in the subgroup aged ≤ 50 years. Favorable clinicopathologic features and active treatments can explain the main causality of the superior prognosis in the high EL group.

키워드

Breast neoplasmsEducationEducational statusPrognosisSurvival analysisantineoplastic agentantineoplastic hormone agonists and antagonistsepidermal growth factor receptor 2estrogen receptorprogesterone receptoradultageArticlebreast cancerbreast radiotherapycancer chemotherapycancer gradingcancer hormone therapycancer patientcancer prognosiscancer radiotherapycancer registrycancer stagingcancer surgerycancer survivalcausalityclinical featurecollegeconfounding variableeducational statusestrogen receptor negative breast cancerestrogen receptor positive breast cancerfemalefollow uphigh schoolhistopathologyhumanhuman epidermal growth factor receptor 2 positive breast cancerlumpectomylymph node metastasislymph vessel metastasismajor clinical studymastectomymiddle agedmiddle schoolmultimodality cancer therapyoverall survivalpostgraduate educationprimary schoolprimary tumorprogesterone receptor positive breast cancersurvival analysissurvival ratetumor volumeuniversitybreast tumorfactual databasehealth surveymetastasismortalityprognosisregisterrisk factorSouth KoreaAdultAge FactorsBreast NeoplasmsCombined Modality TherapyDatabases, FactualFemaleFollow-Up StudiesHumansMiddle AgedNeoplasm MetastasisNeoplasm StagingPopulation SurveillancePrognosisRegistriesRepublic of KoreaRisk FactorsSurvival AnalysisTumor Burden
제목
Education level is a strong prognosticator in the subgroup aged more than 50 years regardless of the molecular subtype of breast cancer: A study based on the Nationwide Korean breast cancer registry database
저자
Hwang, Ki-TaeNoh, WoochulCho, Se-HeonYu, Jonghan Park, Min HoJeong, JoonLee, Hyouk JinKim, JongjinKim, Young A Oh, Sohee Ahn, Sei HyunNoh, Dong-YoungNam, Seok Jin Kim, Sung Yong Lee, Eun SookPark, Byeong-WooNoh, W.C.Yoon, Jung HanLee, Soo Jung Lee, Eun KyuHan, Sehwan Park, Ho YongPaik, Nam-SunBae, Young TaePark, Heung kyuKo, Seung Sang Song, Byung Joo Suh, Young JinJung, Sung HooCho, Se Heon Kim, Sei JoongOh, Se JeongKo, Byung KyunKim, Ku Sang Park, ChanheunBaek, Jong-Min Chang, Il-SungBae, Jeoung Won Kim, Jeong- Soo Kang, Sun HeeGwak, Geumhee Lee, Jee HyunKim, Tae Hyun Chang, Myungchul Lee, Jung SunSong, Jeong-Yoon Park, Hai LinMin, Sun YoungYang, Jung-Hyun Park, Sung HwanPark, Woo-ChanKim, Lee SuRyu, Dong WonKim, Kweon CheonChung, Min Sung Park, Hee Boong Lim, Cheol WanChoi, Un Jong Kwak, Beom Seok Park, Young SamShin, Hyuk JaiChoi, Young Jin Kim, DoyilHan, AiriKoh, Jong Hyun Choi, SangyongYoon, Daesung Choi, Soo YounChul, Shin HeeKim, Jae Il Choi, Jae HyuckRyu, Jin WooKo, Chang DaeLee, Il Kyun Lee, Dong Seok Choi, Seunghye Min, Youn Ki Jeon, Young San Park, Eun-Hwa Korean Breast Cancer Society
DOI
10.4143/crt.2016.528
발행일
2017-02
유형
Article
저널명
Cancer Research and Treatment
49
4
페이지
1114 ~ 1126

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