Is Breast Cancer Problem in India Worse Than That of the West? Reflection of Analysis of Breast Cancer Molecular Subtyping from Tertiary Cancer Care Center in Northern India.

Breast cancer in India is rapidly expanding overtaking cervical cancer in terms of incidence as well as mortality. Indian women with breast cancer are younger, premenopausal and a large proportion of patients present at advanced stages. Considering breast cancer to be a complex disease demonstrating heterogeneity at clinical and histopathological levels, breast cancer in the Indian population could be biologically dhistology and receptor status characterization ifferent from those of the west. We attempt to study the clinical and pathological aspects of breast cancer and its correlation with biomolecular subtyping with comparison to the western population in order to find a pattern of differences. All patients diagnosed and treated in the Department of Surgical Oncology, King George Medical University, Lucknow, UP, from the period of August 2014 to August 2016 are included. Clinical and histopathological data was recorded. A total of 355 patients were analyzed. Average age of patients with disease was 45.3 years. The premenopausal group consists of 52% of patients. Mostly patients presented in locally advanced stage. Triple-negative disease was associated with higher grade of disease (p < 0.0001) and higher rates of lymphovascular invasion (p = 0.040), pericapsular invasion (p = 0.005), and extranodal spread of disease (p < 0.001).This subgroup was significantly higher in premenopausal patients (p =.016). Disease-free survival was lower in triple-negative group. As compared to the western population, the breast cancer in India presents in younger, premenopausal, multiparous, and breast feeding women. Molecular subgrouping reveals that about 60% of the patients are hormone negative. Forty-three percent of patients were triple negative. It appears to be that breast cancer in India is a different subset from the western world in having different molecular signatures that translate into distinct clinical and histopathological subgroup. [ABSTRACT FROM AUTHOR]

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