Journal of Education and Health Promotion

Abstract Background and Objectives: Breast cancer is a major threat to women’s health. Evaluation
of the changes in trend of the incidence rate provides valuable information for the assessment
and planning of development indicators of each country. The aim of the present study was to
apply the JoinPoint regression model for determining changes in the trend of the breast cancer
incidence rate in Isfahan. Materials and Methods: In this cross‑sectional study, 3640 women
with breast cancer referring to oncology and radiotherapy departments of Seyed‑al‑Shohada
and Milad cancer treatment centers of Isfahan during 2001–2010 were studied and sampling
was not done. Joinpoint regression model was used to investigate the pattern of breast
cancer incidence rate. Response and independent variables were the natural logarithm of the
age‑standardized incidence rates and year of diagnosis of breast cancer, respectively, in which
various levels of cancer tumor characteristics (P < 0.05) were analyzed. Results: The incidence
rates increased annually in the age groups of 40–44 years (6.2%), 45–49 years (5.3%), and
55–59 years (5.3%). The trend of incidence rates in women with tumor size ≤2 cm (18.2%),
well (moderately) differentiated tumor grade [8% (10.2%)], positive estrogen (progesterone)
hormone receptor status [10.5% (6.9%)], and the proportion of positive lymph node to surgery
node ≤25% (nonsignificant) was upward. Conclusion: The trend of incidence rates with tumor
size ≤2 cm, well‑differentiated tumor grade, moderately differentiated tumor grade, and positive
estrogen and progesterone hormone receptors was upward. The pattern of breast cancer can
help in cancer prevention and prognosis, and in selecting the best type of surgery.

Abstract Background: Breast cancer is the most common cause of death in women in the age range
of 35‑55 years. Each year, one or two cases of breast cancer per 1000 women are diagnosed
as new cases. Despite the serious prognosis and high rate of morbidity, mortality, and
pathogenicity, in the case of early diagnoses, the prognosis will be better. The aim of this
study was to investigate the age trends in breast cancer patients with different sizes of tumors
in Breast Cancer Research Center of Isfahan University of Medical Sciences in 2001‑2010.
Materials and Methods: The information in radiotherapy and oncology of Isfahan University of
Medical Sciences and Milad Hospital from 2001 to 2010 were coded and analyzed. Frequency
of patients’ age groups, tumor sizes and the year of cancer diagnosis were calculated.
Correlation test was used for data analysis in statistical analysis in social science (SPSS)
software version 18. Findings: Among the 3722 patients with breast cancer, the highest
relative frequency distribution, respectively was observed in the age of 40‑49 years (34.4%),
50‑59 years (26.6%), 30‑39 years (17.7%), 60‑69 years (13.2%), 20‑29 years (2.5%), 70 years
and older (5.2%) and less than 20 years. Relative frequency distribution of tumor sizes in a
variety of 5 cm (T2) was with the frequency of 59.8%, and then 26% at 5 cm (T3), 10.5% at
2 cm (T1), 3.1% at T4 and 0.6 at In‑situ, respectively. Conclusion: The investigation of age
trends showed that diagnosis rate of breast cancer increased from 2001 to 2004. It reached its
highest value in 2006 at the age range of 30‑39 years. Then, the trend has been downward, and
it has continued to decline until 2010, which
could be the result of the equipping screening
system and recording the malignant cases.
85.8% of the examined tumors in T2 and T3
group were visible and may be disturbing.
Comparing the frequency distribution of the
infected population showed that the highest
incidence of breast cancer diagnosis were in
the age range of 40‑49 years. It seems that as
long as the mass has not reached an obvious
palpable state, it has not been diagnosed.