This study was to assess the burden, trends, and risk factors associated with female breast cancer from 1990 to 2021 based on the Global Burden of Disease (GBD) 2021 study. In 2021, there were 20.32 million prevalent cases, 2.08 million incident cases, 0.66 million death cases, and 20.26 million disability-adjusted life years (DALYs). It presented an ascending trend in the age-standardized rates of prevalence and incidence over the past 32 years. The age-standardized DALYs rate (ASDR) increased slightly during 2012-2021. The DALYs increase was primarily driven by population aging and growth. High red meat intake accounted for the highest proportion of ASDR. Breast cancer burden attributed to metabolic risks increased, especially in the regions with low social-development index (SDI) and limited health systems. Dietary, behavior, and metabolic risk factors should be controlled to diminish breast cancer burden, especially in countries with lower SDI.

AbstractBackgroundRecent retrospective studies have reported that breast‐conserving therapy (BCT) led to improved overall survival (OS) than mastectomy in some populations. We aimed to compare the efficacy of BCT and mastectomy using the SEER database.Materials and methodsBetween 2010 and 2015, 99,790 eligible patients were identified. We included early‐stage breast cancer patients with 5cm or smaller tumors and three or fewer positive lymph nodes in our study. We compared the OS and breast cancer‐specific survival (BCSS) results among patients with BCT and those with mastectomy. Kaplan‐Meier plots, Cox proportional hazard regressions, competing risk analysis, and multivariate regressions were used to evaluate the outcomes. Propensity‐score matching was used to assemble a cohort of patients with similar baseline characteristics.ResultsIn our study, 77,452 (77.6%) patients underwent BCT and 22,338 (22.4%) underwent mastectomy. The 5‐year OS rate was 94.7% in the BCT group and 87.6% in the mastectomy group, and the 5‐year BCSS was 97.2% in the BCT and 94.3% in the mastectomy group. Multivariate analysis in the matched cohort showed that women underwent mastectomy was associated with worse OS (Hazard ratio (HR) = 1.79; 95% confidence intervals (CIs) = 1.59–2.02, p < 0.001) and BCSS (HR = 1.88; 95% CIs = 1.61–2.18, p < 0.001) results compared with those underwent BCT. Patients with different subtypes and age group (>50 years old; ≤50 years old) received BCT showed significantly better OS and BCSS results than those received mastectomy. The effect of surgery choice on survival yielded similar results either for all patients or matched cohorts.ConclusionsOur study showed that BCT was associated with improved survival compared with mastectomy in early‐stage breast cancer patients. It seems advisable to encourage patients to receive BCT rather than mastectomy in early‐stage patients when feasible and appropriate.

目的 探讨乳腺囊内乳头状癌(IPC)的临床生物学特性及预后.方法 选取2007年至2017年经手术病理确诊的15例IPC患者(IPC组),随机按1:3比例选择同期浸润性导管癌45例患者(IDC组),比较两组患者的临床病理指标,包括年龄、性别、肿瘤大小、超声表现、钼靶表现、淋巴结转移状况、分子分型、无复发生存等.结果 IPC组与IDC组在发病年龄、性别、超声表现、腋窝淋巴结转移均差异有统计学意义(P<0.05),在肿瘤大小、钼靶表现、分子分型等方面差异无统计学意义(P>0.05).所有患者中位随访63个月(20～96个月),IPC组和IDC组无复发生存率(RFS)分别为93.3％和82.2％,差异无统计学意义(P>0.05).结论 与IDC相比,IPC好发于老年患者,特别是绝经后女性,男性发病较IDC占比更高,超声表现为囊实混合的界清肿块更多见,淋巴结转移更少见;IPC总预后好,对于IPC合并浸润性癌,建议行前哨淋巴结活检评估腋窝.

Background: The effects of marital status on infiltrating ductal carcinoma of breast cancer (IDC) have not been studied in detail. This study investigated the impact of marital status on IDC patients. Material/Methods: SEER databases were searched from 2010 to 2015 for subjects who were married, divorced, single, and wid- owed. The influence of marital status on breast cancer-specific survival (BCSS) and overall survival (OS) of IDC patients was investigated through multivariate Cox regression analysis and Kaplan-Meier analysis. To prevent bias, propensity score matching (PSM) analysis was performed. Results: The 5-year OS was 89.6%in married patients, 84.9% in divorced patients, 83.5% in single patients, and 71.3% in widowed patients (p<0.001). The 5-year BCSS were 92.9%, 90.2%, 87.6%, and 86.4%, respectively (p<0.001). Multivariate Cox regression analysis revealed that marriage was a protective factor for patients with IDC in terms of OS (divorced: HR, 1.27; 95% CI, 1.21-1.32; p<0.001; single: HR, 1.36; 95% CI, 1.31-1.42; p<0.001; widowed: HR, 1.42; 95% CI, 1.36-1.48; p<0.001) and BCSS (divorced: HR, 1.15; 95% CI, 1.09-1.21; p<0.001; single: HR, 1.27; 95% CI, 1.21-1.33; p<0.001; widowed: HR, 1.32; 95% CI, 1.25-1.40; p<0.001). Following subgroup and PSM analysis, married patients were shown to have better OS and BCSS as opposed to divorced, single, or widowed patients. Conclusions: We identify marital status as a predictor of survival in those with IDC. Widowed patients showed the highest mortality risk.