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Is the high proportion of young age at breast cancer onset a unique feature of Asian breast cancer?

  • Epidemiology
  • Published:
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Abstract

Purpose

Women with breast cancer in Asian and Western countries are similar in many respects, but there are also differences, such as in the age at onset and the proportion of breast cancer occurring at younger ages. There is controversy as to whether these differences are due to inter-racial genetic differences or to environmental or other factors.

Methods

Using the Korean Breast Cancer Society’s large breast cancer registry, we investigated the causes of Koreans’ unique breast cancer characteristics by examining the changes in the incidence and proportion of young-onset breast cancer (YBC) in Korea over time. We analyzed data from 108,894 patients to compare characteristics between patients with YBC and non-YBC. For a subtype analysis, we analyzed data from 85,691 patients from 2000.

Results

Among the 108,894 patients, 17,877 (15.5%) had YBC. The tumors associated with YBC showed aggressive clinicopathologic features. The incidence of breast cancer in Korea has increased over time, and while both YBC and non-YBC increased each year, the increase in non-YBC was more pronounced; thus, the proportion of YBC has decreased over time. By 2020, it appears that the ratio of YBC in Korea will be similar to that in Western countries. The increase in YBC was mainly due to an increase in the luminal A subtype. The incidence of other YBC subtypes did not change over time.

Conclusions

Our data suggest that the current high proportion of YBC is probably not a unique feature of breast cancer in Asia but rather a transient phenomenon. Additionally, our results indirectly suggest that there were different causes for breast cancer in different age groups, suggesting the importance of using different approaches for different age groups to establish policies for preventing breast cancer.

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Data availability

Korean breast cancer registry (KBCR) which was used for this study is available with the permission of KBCS (the Korean Breast Cancer Society). I’ll provide the information on where data supporting the results reported in this article can be found including, where applicable, hyperlinks to publicly archived datasets analyzed or generated during the study.

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Acknowledgements

This article was supported by the Korean Breast Cancer Society. We are grateful to the statistical analysis of the Statistics and Data Center, Research Institute for Future Medicine, Samsung Medical Center.

Funding

The authors received no specific funding for this work.

Author information

Author notes

  1. Se Kyung Lee and Seok Won Kim have contributed equally to this work.

Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea

    Se Kyung Lee, Seok Won Kim, Jong-Han Yu, Jeong Eon Lee & Seok Jin Nam

  2. Department of Surgery, Ajou University Hospital, Suwon, Republic of Korea

    Ji Young Kim

  3. Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea

    Joohyun Woo

  4. Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan, Republic of Korea

    Seokwon Lee

  5. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

    Eun-Kyu Kim

  6. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

    Hyeong-Gon Moon

  7. Department of Surgery, Dankook University College of Medicine, Cheil General Hospital, Seoul, Republic of Korea

    Sung Sang Ko

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  1. Se Kyung Lee
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Consortia

Korean Breast Cancer Society

Contributions

SKL, SJN, and SWK conceived and designed the study; the HGM, EKK, JYK, JW, SL, SSK, KBCS constructed the data; SKL and SJN analyzed the data; SKL, SJN, SWK, JHY, and JEL contributed reagents, materials, and/or analysis tools; SKL wrote the manuscript; and JHY, JEL, and the KBCS made other contributions.

Corresponding author

Correspondence to Seok Jin Nam.

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Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

Approval was granted by the Institutional Review Board of Samsung Medical Center (IRB File No. 2015-10-189). This study was performed in accordance with the Declaration of Helsinki.

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Lee, S.K., Kim, S.W., Yu, JH. et al. Is the high proportion of young age at breast cancer onset a unique feature of Asian breast cancer?. Breast Cancer Res Treat 173, 189–199 (2019). https://doi.org/10.1007/s10549-018-4947-z

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