Retrospective comparative analytical study of biological behavior of breast cancers based on hormonal status in premenopausal and postmenopausal women in tertiary care teaching hospital

Author: 
Satishkumar A., Santhi Latha G.R and Padmasree G

Background: Breast tissue is cyclically dependent on hormones. The purpose of this study is to compare the biological behavior of breast cancers based on hormonal receptor status in premenopausal and postmenopausal women and its influence on the quality of life of patients in breast cancer.
Aim: A comparative study to compare the biological behaviour of breast cancers based on hormonal status in premenopausal and postmenopausal women.
Methodology: After obtaining institutional ethical committee approval and informed consent, A total number of 146 patients were planned a Retrospective cohort study was carried out in Department of Radiotherapy, Government General Hospital, Guntur for a period of 8 months May - 2022 to December - 2022. Initially the hormonal receptor status [ER/PR/HER-2] in breast cancer was assessed based on pathology reports. These are categorized into 5 groups i.e., 1)ER/PR/HER2- positive2)ER/PR/HER2-negative3)ER/PR-positive/HER2-negative4)ER/PR-negative/HER2-positive5)Others.The self-designed and validated questionnaire (EORTC QLQ-BR23, HADS, SF-36)was used to assess the quality of life in breast cancer patients which represents the difference between past and present health status of patient.
Results: 146 patients who met the inclusion criteria and were included in the study. The data obtained was tabulated and analyzed. Based on the demographic data obtained it was found that breast cancer was found to be more predominant within the age group 31-40 and 41-50 years. Our study also found that patients were mostly postmenopausal at the time of diagnosis of breast cancer. Among the 146 patients 107 were early stage, 28 metastatic and 11 were diagnosed as recurrence. Of the 28 metastatic patientsb one was found to be the major site of metastas is followed by brain, lung and liver. Among the early and metastatic breast cancer patients postmenopausal women were dominant while in recurrence patients premenopausal were dominant. In premenopausal and postmenopausal women the majority of the receptor status was found to be that of ER/PR-positive /HER2- negative. It was found to be similar in the case of earlier and metastatic breast cancer patients while in the recurrence patients majority of the receptor status was found to be that of ER/PR/HER2-positive.
We analyzed the quality of life of the patient using t-test (P=0.027) and found that there is significant improvement in both functional status and psychosocial status; the difference is found to be statistically significant which indicates that there is improvement in quality of life of the patient before and after providing the therapy.
Conclusion: Based on the results obtained our study concludes that most of the patients are postmenopausal (n=88) at the time of diagnosis of with majority having receptor status ER, PR
+ve, HER2–ve(n=15,10.3%) followed by premenopausal(n=58) with majority having receptor status ER,PR +VE,HER2 -VE(n=16,10.96%). Evaluating the stage of breast cancer most of the patients are presented as early breast cancer majorly having receptor status ER,PR +ve,HER2–ve(n=19 ,13.01%) followed by metastatic breast cancer patients with most having receptor status ER,PR +ve,HER2 –ve(n=12,8.28%) and recurrence with majority having receptor status ER/PR/HER2+ve(n=3,2.05%).
Hence based on the results obtained in our study we strongly conclude that irrespective of the menopausal state and stage at the time of diagnosis, majority of the patients were diagnosed with receptor status ER,PR +VE,HER2 -VE (n=31, 21.23%) and also found that the patients diagnosed at postmenopausal state were more prone to metastasis and patients diagnosed at premenopausal state were prone to recurrence.
Our study concludes that pharmaceutical care and psychosocial support and the provided patient information leaflet which was mainly focused on healthy diet plays a vital role in improving adherence to the therapy there by enhancing the quality of life of the patients with early, metastatic, recurrence breast cancer being under follow up and/or hormonal therapy after providing with surgery and/or radiation therapy and/or chemotherapy.

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DOI: 
http://dx.doi.org/10.24327/ijcar.2023.1940.1424
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