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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

Authors
 Ki-Tae Hwang  ;  Woochul Noh  ;  Se-Heon Cho  ;  Jonghan Yu  ;  Min Ho Park  ;  Joon Jeong  ;  Hyouk Jin Lee  ;  Jongjin Kim  ;  Sohee Oh  ;  Young A Kim  ;  Korean Breast Cancer Society 
Citation
 Cancer Research and Treatment, Vol.49(4) : 1114-1126, 2017 
Journal Title
 Cancer Research and Treatment 
ISSN
 1598-2998 
Issue Date
2017
Keywords
Breast neoplasms ; Education ; Educational status ; Prognosis ; Survival analysis
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.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161071
DOI
10.4143/crt.2016.528
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
정준(Jeong, Joon)
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