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Review
. 2016 Jun 29;2(6):412-421.
doi: 10.1200/JGO.2016.005397. eCollection 2016 Dec.

Prevalence of Triple-Negative Breast Cancer in India: Systematic Review and Meta-Analysis

Gurprataap S Sandhu  1 , Sebhat Erqou  1 , Heidi Patterson  1 , Aju Mathew  1
Affiliations
Review

Prevalence of Triple-Negative Breast Cancer in India: Systematic Review and Meta-Analysis

Gurprataap S Sandhu et al. J Glob Oncol. .

Abstract

Purpose: There is considerable variation in prevalence rates of triple-negative breast cancer (TNBC) reported by various studies from India. We performed a systematic review and literature-based meta-analysis of these studies.

Methods: We searched databases of Medline, Scopus, EMBASE, and Web of Science for studies that reported on the prevalence of TNBC in India that were published between January 1, 1999, and December 31, 2015. We extracted relevant information from each study by using a standardized form. We pooled study-specific estimates by using random-effects meta-analysis to provide summary estimates. We explored sources of heterogeneity by using subgroup analyses and metaregression.

Results: Data were obtained from 17 studies that involved 7,237 patients with breast cancer. Overall combined prevalence of TNBC was 31% (95% CI, 27% to 35%). There was substantial heterogeneity across the studies (I2 of 91% [95% CI, 88% to 94%]; P < .001) that was not explained by available study level characteristics, including study location, definition of human epidermal growth factor receptor 2 or estrogen receptor, mean age of participants, proportion of patients with premenopausal cancer, grade 3 disease, or tumor size > 5 cm. Overall combined prevalence of hormone receptor-positive and human epidermal growth factor receptor 2-positive breast cancer was 48% (95% CI, 42% to 54%) and 27% (95% CI, 24% to 31%), respectively. There was no evidence of publication bias.

Conclusion: Prevalence of TNBC in India is considerably higher compared with that seen in Western populations. As many as as one in three women with breast cancer could have triple-negative disease. This finding has significant clinical relevance as it may contribute to poor outcomes in patients with breast cancer in India. Additional research is needed to understand the determinants of TNBC in India.

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Conflict of interest statement

Authors’ disclosures of potential conflicts of interest and contributions are found at the end of this article.The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc. Gurprataap S. SandhuNo relationship to discloseSebhat ErqouNo relationship to discloseHeidi PattersonNo relationship to discloseAju MathewNo relationship to disclose

Figures

Fig 1
Fig 1
Flow diagram for identifying studies for assessment of prevalence of triple-negative breast cancer in India.
Fig 2
Fig 2
Prevalence of triple-negative breast cancer across 17 studies in India. E, east; N, north; S, south; W, west.
Fig 3
Fig 3
Prevalence of hormone receptor–positive breast cancer across 17 studies in India. E, east; N, north; S, south; W, west.
Fig 4
Fig 4
Prevalence of human epidermal growth factor receptor 2–positive breast cancer across 17 studies in India. E, east; N, north; S, south; W, west.
Fig 5
Fig 5
Prevalence of triple negative breast cancer by various study characteristics. ER, estrogen receptor; HER2, human epidermal growth factor receptor 2.
Fig A1
Fig A1
Funnel plot with pseudo 95% CIs. TNBC, triple-negative breast cancer.
See this image and copyright information in PMC

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