Socio-economic Factors Influencing Tumor Presentation and Treatment Options in Chinese Breast Cancer Patients

Abstract

The impact of income and education level on the clinical and pathologic characteristics, implementation ofclinical breast examination (CBE), and treatment patterns of a small population of Chinese female breast cancerpatients was studeied in order to provide a theoretical basis and statistical reference for further nationwideresearch. We included 484 pathologically confirmed female primary breast cancer inpatients of the FirstAffiliated Hospital of Medical College of Xi’an Jiaotong University from February 2003 to January 2004. Allcases were reviewed and relevant information was collected using a designed case report form (CRF). Chisquaretests, rank-sum tests, and Fisher’s exact tests were used in the analysis. Our analysis showed that: (1)women in different occupation groups had significant differences in tumor size, pre-operative mammography,surgical options, post-operative estrogen receptor (ER), progestin receptor (PR) and human epidermal growthfactor receptor 2 (Her2) status, and post-operative radiotherapy and chemotherapy (P < 0.05); and (2) womenwith different education levels had statistically significant differences in tumor size, post-operative ER, PR andHer2 status, and post-operative chemotherapy, radiotherapy, and endocrine therapy (P < 0.05). In Xi’an, China,women in low-income occupations or with low education levels are more likely to have advanced tumor stagesat presentation, lower implementation rate of clinical breast examination, and less treatment.