RISK FACTORS OF BREAST CANCER AMONG YOUNG WOMEN IN SULAIMANI GOVERNORATE: A HOSPITALBASED CASE-CONTROL STUDY

Authors

  • Tavan Taha Hama Saeed Ministry of Health, Kurdistan Region, Iraq.
  • Mezjda Ismail Rashaan Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Nizar Mohamed Tawfeeq Hamawandi Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Hawar Hassan Ali Naqshbandi Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

DOI:

https://doi.org/10.17656/jsmc.10441

Keywords:

Breast cancer, young women, case-control studies, risk factors

Abstract

Background
Breast cancer is the most common type of cancer in women throughout the world. Although uncommon, breast cancer is the leading cause of cancer death in young women.


Objective
To assess risk factors among young Kurdish women ≤ 40 in Sulaimani governorate.


Materials and Methods
A hospital-based, retrospective case-control study was conducted in two selected Sulaimani Hospitals, Hiwa Cancer Hospital and Breast Diseases Center, from January 1st, 2015, to December 31st, 2021. Eligible cases included those women ≤ 40 years of age, Kurdish nationality, histopathologically confirmed breast cancer, and random selection of a control group with no evidence of breast cancer of matched age. Data on reproductive characteristics were collected through a standardized questionnaire for both cases and controls.


Results
The participants’ mean age was 32.23 years (SD ±3.98) and 34.55 years (SD ±5.99) for cases and controls, respectively. The results of multinomial logistic regression revealed that menarche at 12-14 years of age (OR= 2.33, 95% CI:1.41 - 3.86), low level of education (OR primary= 2.16, 95% CI:1.32 - 3.53), living in urban areas (OR= 2.75, 95% CI:1.87 - 4.05), unemployment (OR= 2.73, 95% CI:1.34 - 5.53), nulliparity (OR= 1.76, 95% CI:1.1 - 2.83), physical inactivity (OR nil= 5.03, 95% CI:1.09 - 23.3), and some dietary items as (red meat, chicken meat, fish meat) increased the odds of developing BC.


Conclusion
Nulliparity, early age at menarche, physical inactivity, and dietary patterns should be given priority during the assessment of breast cancer risk among young Kurdish-Iraqi women.

References

Amin BA, Babakir-Mina M, Mohialdeen FA, Gubari MI. Knowledge, attitude and practice toward breast cancer among Kurdish Women in Sulaimani Governorate/Iraq. Kurdistan Journal of Applied Research. 2017;2(2):20-8.

Giaquinto AN, Sung H, Miller KD, Kramer JL, Newman LA, Minihan A, et al. Breast cancer statistics, 2022. CA: A Cancer Journal for Clinicians. 2022;72(6):524-41

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.

Gómez-Flores-Ramos L, Álvarez-Gómez RM, VillarrealGarza C, Wegman-Ostrosky T, Mohar A. Breast cancer genetics in young women: What do we know? Mutation Research/Reviews in Mutation Research. 2017; 774:33-45.

Sopik V. International variation in breast cancer incidence and mortality in young women. Breast Cancer Research and Treatment. 2021; 186:497-507.

Al-Hashimi MM. Trends in breast cancer incidence in Iraq during the period 2000-2019. Asian Pacific journal of cancer prevention: APJCP. 2021;22(12):3889.

Kudela E, Samec M, Kubatka P, Nachajova M, Laucekova Z, Liskova A, et al. Breast cancer in young women: status quo and advanced disease management by a predictive, preventive, and personalized approach. Cancers. 2019;11(11):1791.

Dubsky PC, Gnant MF, Taucher S, Roka S, Kandioler D, Pichler-Gebhard B, et al. Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer. Clinical breast cancer. 2002;3(1):65-72.

Sun X, Liu J, Ji H, Yang M, Lu Y. Clinicopathological Characteristics and Prognosis of Breast Cancer in Young Women–A Single Center Study in a Developing Country. Cancer Management and Research. 2021; 13:1601.

Alwan N. Breast cancer: demographic characteristics and clinicopathological presentation of patients in Iraq. EMHJ-Eastern Mediterranean Health Journal, 16 (11), 1159–1164, 2010. 2010.

Hartaningsih NMD, IW S. Kanker Payudara Pada Wanita Usia Muda di Bagian Bedah Onkologi Rumah Sakit Umum Pusat Sanglah Denpasar Tahun 2002–2012. E-Jurnal Medika Udayana. 2014;3(6):1-13.

Gabriel CA, Domchek SM. Breast cancer in young women. Breast cancer research. 2010;12(5):1-10.

Mehdi I, Monem EA, Al Bahrani BJ, Al Kharusi S, Nada AM, Al Lawati J, et al. Age at diagnosis of female breast cancer in Oman: Issues and implications. South Asian journal of cancer. 2014;3(02):101-6.

Fazel A, Hasanpour-Heidari S, Salamat F, Rajaie S, Kazeminezhad V, Naeimi-Tabiei M, et al. Marked increase in breast cancer incidence in young women: A 10-year study from Northern Iran, 2004–2013. Cancer epidemiology. 2019; 62:101573.

Unger JM, Moseley A, Symington B, Chavez-MacGregor M, Ramsey SD, Hershman DL. Geographic distribution and survival outcomes for rural patients with cancer treated in clinical trials. JAMA Network Open. 2018;1(4): e181235-e.

Nagrani R, Budukh A, Koyande S, Panse N, Mhatre S, Badwe R. Rural-urban differences in breast cancer in India. Indian Journal of Cancer. 2014;51(3):277.

Lawson JS. The link between socioeconomic status and breast cancer- a possible explanation. Scandinavian journal of public health. 1999;27(3):203-5.

Thakur P, Seam RK, Gupta MK, Gupta M, Sharma M, Fotedar V. Breast cancer risk factor evaluation in a Western Himalayan state: A case-control study and comparison with the Western World. South Asian J Cancer. 2017;6(3):106-9

Altaha MA, Al-ani HG. Reproductive factors and risk of breast cancer. risk. 2013;6(7):8.

Narod S. Women with Cancer in low-income countries. Current Oncology. 2017;24(4):217-9.

Fei X, Wu J, Kong Z, Christakos G. Urban-rural disparity of breast cancer and socioeconomic risk factors in China. PLoS One. 2015;10(2): e0117572.

Tehard B, Lahmann PH, Riboli E, Clavel-Chapelon F. Anthropometry, breast cancer and menopausal status: Use of repeated measurements over ten years of follow-up—French E3N women's cohort study results. International journal of

cancer. 2004;111(2):264-9.

Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. The Lancet. 2008;371(9612):569-78.

Hopper JL, Dite GS, MacInnis RJ, Liao Y, Zeinomar N, Knight JA, et al. Age-specific breast cancer risk by body mass index and familial risk: prospective family study cohort (ProF-SC). Breast Cancer Research. 2018;20(1):1-11.

Rose DP, Vona-Davis L. Interaction between menopausal status and obesity in affecting breast cancer risk. Maturitas. 2010;66(1):33-8.

Rockhill B, Willett WC, Hunter DJ, Manson JE, Hankinson SE, Spiegelman D, et al. Physical activity and

breast cancer risk in a cohort of young women. Journal of the National Cancer Institute. 1998;90(15):1555-160.

Hardefeldt PJ, Penninkilampi R, Edirimanne S, Eslick GD. Physical activity and weight loss reduce the risk of breast cancer: a meta-analysis of 139 prospective and retrospective studies. Clinical breast cancer. 2018;18(4): e601-e12.

Chen X, Wang Q, Zhang Y, Xie Q, Tan X. Physical activity and risk of breast cancer: a meta-analysis of 38 cohort studies in 45 study reports. Value in Health. 2019;22(1):104-28.

Ruiz RB, Hernández PS. Diet and cancer: risk factors and epidemiological evidence. Maturitas. 2014;77(3):202-8.

Gaudet MM, Gapstur SM, Sun J, Diver WR, Hannan LM, Thun MJ. Active smoking and breast cancer risk: original cohort data and meta-analysis. Journal of the National Cancer Institute. 2013;105(8):515-25.

Cathcart-Rake EJ, Ruddy KJ, Johnson RH. Modifiable risk factors for the development of breast cancer in young women. The Cancer Journal. 2018;24(6):275-84.

Macacu A, Autier P, Boniol M, Boyle P. Active and passive smoking and risk of breast cancer: a meta-analysis. Breast cancer research and treatment. 2015;154(2):213-24.

Van Gils CH, Peeters PH, Bueno-de-Mesquita HB, Boshuizen HC, Lahmann PH, Clavel-Chapelon F, et al. Consumption of vegetables and fruits and risk of breast cancer. Jama. 2005;293(2):183-93.

Cho E, Spiegelman D, Hunter DJ, Chen WY, Stampfer MJ, Colditz GA, et al. Premenopausal fat intake and risk of breast cancer. Journal of the National Cancer Institute. 2003;95(14):1079-85.

Nanri A, Mizoue T, Shimazu T, Ishihara J, Takachi R, Noda M, Iso H, et al., Japan Public Health Center-Based Prospective Study Group. Dietary patterns and all-cause, cancer, and cardiovascular disease mortality in Japanese men and women: The Japan public health center-based prospective study. PLoS One. 2017 Apr 26;12(4): e0174848.

Rezaianzadeh A, Ghorbani M, Rezaeian S, Kassani A. Red meat consumption and breast cancer risk in premenopausal women: A systematic review and metaanalysis. Middle East Journal of Cancer. 2018;9(1):5-12.

Farvid MS, Stern MC, Norat T, Sasazuki S, Vineis P, Weijenberg MP, et al. Consumption of red and processed meat and breast cancer incidence: A systematic review and meta-analysis of prospective studies. International journal of cancer. 2018;143(11):2787-99.

Fararouei M, Iqbal A, Rezaian S, Gheibi Z, Dianatinasab A, Shakarami S, et al. Dietary habits and physical activity are associated with the risk of breast cancer among young Iranian women: a case-control study on 1010 premenopausal women. Clinical breast cancer. 2019;19(1): e127-e34.

Dai Q, Shu X-o, Jin F, Gao Y-T, Ruan Z-X, Zheng W. Consumption of animal foods, cooking methods, and risk of breast cancer. Cancer Epidemiology Biomarkers & Prevention. 2002;11(9):801-8.

Stripp C, Overvad K, Christensen J, Thomsen BL, Olsen A, Møller S, et al. Fish Intake Is Positively Associated with Breast Cancer Incidence Rate. The Journal of Nutrition. 2003;133(11):3664-9.

Zang J, Shen M, Du S, Chen T, Zou S. The association between dairy intake and breast cancer in Western and Asian populations: a systematic review and meta-analysis. Journal of breast cancer. 2015;18(4):313-22.

Moorman PG, Terry PD. Consumption of dairy products and the risk of breast cancer: a review of the literature. The American journal of clinical nutrition. 2004;80(1):5-14.

Ghiasvand R, Maram ES, Tahmasebi S, Tabatabaee SHR. Risk factors for breast cancer among young women in southern Iran. International journal of cancer. 2011;129(6):1443-9.

Peeters P, Verbeek A, Krol A, Matthyssen M, De Waard F. Age at menarche and breast cancer risk in nulliparous women. Breast cancer research and treatment. 1995;33(1):55-61.

Laamiri FZ, Hasswane N, Kerbach A, Aguenaou H, Taboz Y, Benkirane H, et al. Risk factors associated with breast cancer in a population of Moroccan women whose age is less than 40 years: a case-control study. Pan African Medical Journal. 2016;24(1).

Butt Z, Haider SF, Arif S, Khan MR, Ashfaq U, Shahbaz U, et al. Breast cancer risk factors: a comparison between premenopausal and postmenopausal women. JPMA-Journal of the Pakistan Medical Association. 2012;62(2):120.

Memon ZA, Kanwal N, Sami M, Larik PA, Farooq MZ. Risk of breast cancer among young women and importance of early screening. Asian Pacific Journal of Cancer Prevention. 2015;16(17):7485-9.

Parazzini F, La Vecchia C, Negri E, Franceschi S, Tozzi L. Lifelong menstrual pattern and risk of breast cancer. Oncology. 1993;50(4):222-5.

Abedalrahman SK, Ali BM, Al-Khalidy N, Al-Hashimi A. Risk factors of breast cancer among Iraqi women. Journal of Contemporary Medical Sciences. 2019;5(3):149-53.

Russo J, Moral R, Balogh GA, Mailo D, Russo IH. The protective role of pregnancy in breast cancer. Breast cancer research. 2005;7(3):1-12.

Tavani A, Gallus S, La Vecchia C, Negri E, Montella M, Dal Maso L, et al. Risk factors for breast cancer in women under 40 years. European Journal of Cancer. 1999;35(9):1361-7.

Clavel-Chapelon F, Gerber M. Reproductive factors and breast cancer risk. Do they differ according to age at diagnosis? Breast cancer research and treatment. 2002;72(2):107-15.

McCredie M, Paul C, Skegg DC, Williams S. Reproductive factors and breast cancer in New Zealand. International journal of cancer. 1998;76(2):182-8.

Bensaber H, Bicout D, Bensnouci A, Comez A, El Kébir F, Chebloune Y. Risk Factors of Breast Cancer Among Western Algerian Women Under 40. Med Clin Res, 2021 6 (3): 422. 2021;426.

Rodriguez AO, Chew H, Cress R, Xing G, McElvy S, Danielsen B, et al. Evidence of poorer survival in pregnancyassociated breast cancer. Obstetrics & Gynecology. 2008;112(1):71-8.

Cancer CGoHFiB. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50 302 women with breast cancer and 96 973 women without the disease. The Lancet. 2002;360(9328):187-95.

Hadjisavvas A, Loizidou MA, Middleton N, Michael T, Papachristoforou R, Kakouri E, et al. An investigation of breast cancer risk factors in Cyprus: a case-control study. BMC cancer. 2010;10(1):1-10.

Lord SJ, Bernstein L, Johnson KA, Malone KE, McDonald JA, Marchbanks PA, et al. Breast cancer risk and hormone receptor status in older women by parity, age of first birth, and breastfeeding: a case-control study. Cancer Epidemiology Biomarkers & Prevention. 2008;17(7):1723-30.

Mahue-Giangreco M, Ursin G, Sullivan-Halley J, Bernstein L. Induced abortion, miscarriage, and breast cancer risk of young women. Cancer Epidemiology Biomarkers & Prevention. 2003;12(3):209-14.

Henderson KD, Sullivan-Halley J, Reynolds P, HornRoss PL, Clarke CA, Chang ET, et al. Incomplete pregnancy is not associated with breast cancer risk: The California Teachers Study. Contraception. 2008;77(6):391-6.

HOWE HL, SENIE RT, BZDUCH H, HERZFELD P. Early abortion and breast cancer risk among women under age 40. International journal of epidemiology. 1989;18(2):300-4.

Cancer CGoHFiB. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. The Lancet. 1996;347(9017):1713-27.

Weiss HA, Brinton LA, Potischman NA, Brogan D, Coates RJ, Gammon MD, et al. Breast cancer risk in young women and history of selected medical conditions. International journal of epidemiology. 1999;28(5):816-23.

Phipps AI, Li CI, Kerlikowske K, Barlow WE, Buist DS. Risk Factors for Ductal, Lobular, and Mixed Ductal-Lobular Breast Cancer in a Screening Population Risk Factors for Histologic Types of Breast Cancer. Cancer epidemiology, biomarkers & prevention. 2010;19(6):1643-54.

Ghosh K, Pankratz V, Reynolds C, Vierkant R, Anderson S, Degnim A, et al. Benign breast disease and breast cancer risk in young women. Cancer Research. 2009;69(2_ Supplement):62.

Adedokun B, Odedina S, Ojengbede O, Ademola A, Ogundiran T, Huo D, et al. A case-control study of benign breast disease and breast cancer among indigenous African women. Cancer Research. 2019;79(13_Supplement):624-.

Kim EY, Chang Y, Ahn J, Yun JS, Park YL, Park CH, et al. Mammographic breast density, its changes, and breast cancer risk in premenopausal and postmenopausal women. Cancer. 2020;126(21):4687-96.

Published

2023-12-21

How to Cite

1.
Saeed T, Rashaan M, Hamawandi N, Naqshbandi H. RISK FACTORS OF BREAST CANCER AMONG YOUNG WOMEN IN SULAIMANI GOVERNORATE: A HOSPITALBASED CASE-CONTROL STUDY. JSMC [Internet]. 2023 Dec. 21 [cited 2024 Jul. 19];13(4):11. Available from: https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10441

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