1. 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
- Author
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Woochul Noh, Se-Heon Cho, Young A Kim, Joon Jeong, Min Ho Park, Ki-Tae Hwang, Jongjin Kim, Hyouk Jin Lee, Sohee Oh, and Jonghan Yu
- Subjects
Oncology ,Adult ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,Databases, Factual ,medicine.medical_treatment ,Breast Neoplasms ,Education ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Risk Factors ,Internal medicine ,Republic of Korea ,Medicine ,Humans ,030212 general & internal medicine ,Registries ,Neoplasm Metastasis ,Survival analysis ,Neoplasm Staging ,Educational status ,business.industry ,Lumpectomy ,Hazard ratio ,Confounding ,Age Factors ,Middle Aged ,medicine.disease ,Prognosis ,Combined Modality Therapy ,Confidence interval ,Tumor Burden ,Radiation therapy ,030220 oncology & carcinogenesis ,Population Surveillance ,Original Article ,Female ,business ,Follow-Up Studies - Abstract
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.
- Published
- 2017