Radiological and Clinicopathological Profiles Between Early- versus Advanced-Stage of Breast Cancer: a Single-Centre Comparative Study
Keywords:
Breast cancer, early stage, advanced stage, radiology, histopathology, hormone receptor, HER2, Ki-67Abstract
Introduction: Breast cancer remains a leading cause of morbidity and mortality among women worldwide, with significant clinical and pathological differences between early and advanced stages. Understanding these differences is crucial for improving diagnosis and treatment strategies.
Methods: This cross-sectional, descriptive correlational study reviewed 40 medical records of female breast cancer patients treated at Ibnu Sina Hospital, Makassar. Patients were divided into early-stage (n=20) and advanced-stage (n=20) groups. Clinical, radiological, and histopathological data were collected, including tumor size, lymph node involvement, hormone receptor status, HER2 expression, and proliferation index (Ki-67).
Results: The average age was 45 years in early-stage and 58 years in advanced-stage patients. Early-stage tumors were smaller (average 1.5 cm), well-differentiated, hormone receptor-positive, and showed low Ki-67 proliferation. Advanced-stage tumors were larger (average 4-6.2 cm), poorly differentiated, with higher HER2 positivity, increased lymph node involvement, distant metastasis, and higher Ki-67 index. Radiologically, early tumors appeared as regular, hypoechoic masses with clear margins, while advanced tumors showed irregular shapes, necrosis, neovascularization, calcifications, and breast wall infiltration.
Discussion: Significant radiological and clinicopathological differences exist between early and advanced breast cancer stages, reflecting tumor aggressiveness and progression. These findings align with previous studies emphasizing the importance of early detection and tailored treatment.
Conclusion: Recognizing distinct features of early versus advanced breast cancer is essential for optimizing patient management. Further multicenter studies with larger cohorts are recommended to enhance understanding and improve outcomes.
Downloads
Metrics
References
for Research on Cancer IA, others. Global cancer observatory (GCO). World Heal Organ Agency Res Cancer. 2020;
RI K. Data Kanker Payudara di Indonesia. Jakarta: Kementerian Kesehatan Republik Indonesia; 2023.
World Health Organization. Breast Cancer Fact Sheet [Internet]. [cited 2025 Apr 27]. Available from: https://www.who.int/news-room/fact-sheets/detail/breast-cancer
MA F, F T. Breast Cancer. Baghdad; 2022.
Callari M, Cappelletti V, D’Aiuto F, Musella V, Lembo A, Petel F, et al. Subtype-specific metagene-based prediction of outcome after neoadjuvant and adjuvant treatment in breast cancer. Clin Cancer Res. 2016;22(2):337–45.
WA BRG. Diagnostic accuracy of mammography, clinical examination, US, and MR imaginng in preoperative assessment of breast cancer. Radiology. 2004;233:830–49.
Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK, et al. AJCC cancer staging manual. Vol. 1024. Springer; 2017.
Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin. 2017;67(2):93–9.
Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol. 2013;24(9):2206–23.
MS A, AA A, AM A, NA A, KF A, A S. Molecular subtypes of breast cancer: current role in diagnosis, prognosis and therapy. Pathophysiology. 2020;27(4):100565.
Wahidin M, Djuwita R, Adisasmita A. Oral contraceptive and breast cancer risks: A case control study in six referral hospitals in Indonesia. Asian Pacific J cancer Prev APJCP. 2018;19(8):2199.
Lodi M, Scheer L, Reix N, Heitz D, Carin A-J, Thiébaut N, et al. Breast cancer in elderly women and altered clinico-pathological characteristics: a systematic review. Breast Cancer Res Treat. 2017;166:657–68.
Ibrahim AS, Khaled HM, Mikhail NNH, Baraka H, Kamel H. Cancer incidence in Egypt: results of the national population-based cancer registry program. J Cancer Epidemiol. 2014;2014(1):437971.
S N, M O, A M, T O. Significance of high-resolution ultrasound in the early detection of breast cancer: correlation between tumor size and prognostic factors. Ultrasound Med Biol. 2020;46(3):642–50.
Y L, J C, Y Z, S Z, Y X, X W. Ultrasound features of breast cancer: association with tumor characteristics and molecular subtypes. Eur Radiol. 2023;33(1):119–25.
Ji C-L, Li X-L, He Y-P, Li D-D, Gu X-G, Xu H-X. Quantitative parameters of contrast-enhanced ultrasound in breast invasive ductal carcinoma: The correlation with pathological prognostic factors. Clin Hemorheol Microcirc. 2017;66(4):333–45.
Araki K, Ito Y, Fukada I, Kobayashi K, Miyagawa Y, Imamura M, et al. Predictive impact of absolute lymphocyte counts for progression-free survival in human epidermal growth factor receptor 2-positive advanced breast cancer treated with pertuzumab and trastuzumab plus eribulin or nab-paclitaxel. BMC Cancer. 2018;18:1–7.
G M, R M, S F, E G, C C, I M. Prognostic factors for distant recurrence in patients with multifocal-multicentric breast cancer. Breast Cancer Res Treat. 2021;189(3):851–8.
M R, S M, MA K, MH Z. Mechanobiology of tumor cell differentiation in breast cancer and its clinical implications. Cell Mol Bioeng. 2022;15(1):21–8.
Y X, L L, G G, S T, Z W, M J. Comparative proteomic analysis of breast cancer revealed altered expression of key proteins related to lymph node metastasis. Proteomics Clin Appl. 2022;16(1).
Turner NC, Slamon DJ, Ro J, Bondarenko I, Im S-A, Masuda N, et al. Overall survival with palbociclib and fulvestrant in advanced breast cancer. N Engl J Med. 2018;379(20):1926–36.
Jia M, Gao X, Zhang Y, Hoffmeister M, Brenner H. Different definitions of CpG island methylator phenotype and outcomes of colorectal cancer: a systematic review. Clin Epigenetics. 2016;8:1–14.
K S, US T, L L, MG G, Jakubowski J TM. Delayed and attenuated platelet inhibition response in patients with metabolic syndrome after moderate clopidogrel dose while undergoing percutaneous coronary intervention and relationship to resistin levels. Am J Cardiol. 2020;115(10):1380–6.
X Z, L C, L L, X N. HER2-positive breast cancer is associated with an increased risk of positive margins after initial lumpectomy: a retrospective analysis. World J Surg Oncol. 2020;18(1):228.
Yerushalmi R, Woods R, Ravdin PM, Hayes MM, Gelmon KA. Ki67 in breast cancer: prognostic and predictive potential. Lancet Oncol. 2010;11(2):174–83.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
