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

Korean Breast Cancer Society

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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.

Original languageEnglish
Pages (from-to)1114-1126
Number of pages13
JournalCancer Research and Treatment
Volume49
Issue number4
DOIs
StatePublished - 2017 Jan 1

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Registries
Databases
Breast Neoplasms
Education
Confidence Intervals
Segmental Mastectomy
Causality
Radiotherapy
Multivariate Analysis
Drug Therapy

Keywords

  • Breast neoplasms
  • Education
  • Educational status
  • Prognosis
  • Survival analysis

Cite this

@article{32bc4ddba6ab402bb5b833b7ff31fb84,
title = "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",
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.",
keywords = "Breast neoplasms, Education, Educational status, Prognosis, Survival analysis",
author = "{Korean Breast Cancer Society} and Hwang, {Ki Tae} and Woochul Noh and Cho, {Se Heon} and Jonghan Yu and Park, {Min Ho} and Joon Jeong and Lee, {Hyouk Jin} and Jongjin Kim and Sohee Oh and Kim, {Young A.} and Ahn, {Sei Hyun} and Noh, {Dong Young} and Nam, {Seok Jin} and Kim, {Sung Yong} and Lee, {Eun Sook} and Park, {Byeong Woo} and Noh, {Woo Chul} and Yoon, {Jung Han} and Lee, {Soo Jung} and Lee, {Eun Kyu} and Sehwan Han and Park, {Ho Yong} and Paik, {Nam Sun} and Bae, {Young Tae} and Park, {Heung kyu} and Ko, {Seung Sang} and Song, {Byung Joo} and Suh, {Young Jin} and Jung, {Sung Hoo} and Cho, {Se Heon} and Kim, {Sei Joong} and Oh, {Se Jeong} and Ko, {Byung Kyun} and Kim, {Ku Sang} and Chanheun Park and Baek, {Jong Min} and Chang, {Il Sung} and Bae, {Jeoung Won} and Kim, {Jeong Soo} and Kang, {Sun Hee} and Geumhee Gwak and Lee, {Jee Hyun} and Kim, {Tae Hyun} and Myungchul Chang and Lee, {Jung Sun} and Song, {Jeong Yoon} and Park, {Hai Lin} and Min, {Sun Young} and Yang, {Jung Hyun} and Park, {Sung Hwan}",
year = "2017",
month = "1",
day = "1",
doi = "10.4143/crt.2016.528",
language = "English",
volume = "49",
pages = "1114--1126",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
number = "4",

}

TY - JOUR

T1 - Education level is a strong prognosticator in the subgroup aged more than 50 years regardless of the molecular subtype of breast cancer

T2 - A study based on the Nationwide Korean breast cancer registry database

AU - Korean Breast Cancer Society

AU - Hwang, Ki Tae

AU - Noh, Woochul

AU - Cho, Se Heon

AU - Yu, Jonghan

AU - Park, Min Ho

AU - Jeong, Joon

AU - Lee, Hyouk Jin

AU - Kim, Jongjin

AU - Oh, Sohee

AU - Kim, Young A.

AU - Ahn, Sei Hyun

AU - Noh, Dong Young

AU - Nam, Seok Jin

AU - Kim, Sung Yong

AU - Lee, Eun Sook

AU - Park, Byeong Woo

AU - Noh, Woo Chul

AU - Yoon, Jung Han

AU - Lee, Soo Jung

AU - Lee, Eun Kyu

AU - Han, Sehwan

AU - Park, Ho Yong

AU - Paik, Nam Sun

AU - Bae, Young Tae

AU - Park, Heung kyu

AU - Ko, Seung Sang

AU - Song, Byung Joo

AU - Suh, Young Jin

AU - Jung, Sung Hoo

AU - Cho, Se Heon

AU - Kim, Sei Joong

AU - Oh, Se Jeong

AU - Ko, Byung Kyun

AU - Kim, Ku Sang

AU - Park, Chanheun

AU - Baek, Jong Min

AU - Chang, Il Sung

AU - Bae, Jeoung Won

AU - Kim, Jeong Soo

AU - Kang, Sun Hee

AU - Gwak, Geumhee

AU - Lee, Jee Hyun

AU - Kim, Tae Hyun

AU - Chang, Myungchul

AU - Lee, Jung Sun

AU - Song, Jeong Yoon

AU - Park, Hai Lin

AU - Min, Sun Young

AU - Yang, Jung Hyun

AU - Park, Sung Hwan

PY - 2017/1/1

Y1 - 2017/1/1

N2 - 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.

AB - 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.

KW - Breast neoplasms

KW - Education

KW - Educational status

KW - Prognosis

KW - Survival analysis

UR - http://www.scopus.com/inward/record.url?scp=85030781064&partnerID=8YFLogxK

U2 - 10.4143/crt.2016.528

DO - 10.4143/crt.2016.528

M3 - Article

C2 - 28161933

AN - SCOPUS:85030781064

VL - 49

SP - 1114

EP - 1126

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 4

ER -