Influence of Educational background in Pathological Stage and Treatment Modalities in Iranian Breast Cancer Patients: A Retrospective Single Center Study

Abstract Background: Breast cancer is the most frequent diagnosed visceral cancer with 13400 new cases annually in Iranian women. There are a few studies in the west countries that indicates that breast cancer patients with higher educational background had better prognosis than patients with lower education background.Objectives: In a retrospective single center study we compared educational background and its relationship to pathological stage and their treatment modalities among 3010 breast cancer patients.Methods: Medical records of 3010 patients with breast cancer from database at Cancer Research Center of the Shahid Beheshti University of Medical Sciences were reviewed and univariate logistic regression analysis was used for association between education background and its relationship to pathological breast cancer stage and treatment modalities.Results: The average age at diagnosis was 49.1 years ± 11.6 years. The proportion of breast cancer patients’ levels of education were 4.2 % illiterate, 7.8% primary school, 7.5% middle school, 21.8% high school and diploma, 18.6% university and above and 40.1% unspecified.Based on univariate logistic regression analysis, the illiterate group had 65.1% of early stage breast cancer (stage I and stage II), and the university and above group had 73.4% of early stage breast cancer (p-value<.001). The rate of receiving chemotherapy, radiotherapy and endocrine therapy was in the illiterate group 35.7%, 42.1%, 50% and was in the university and above group 93.7%, 64.3% and 71.1% respectively(p-value<.001). The rate of breast conserving surgery (BCS) in the illiterate group, the primary school, the middle school, the high school and diploma, and the university and above group was 15.1%, 18%, 16.3%, 42.5%, and 73.2% respectively (p-value<.001).Conclusions: The findings of this study showed that education background have a significant impact on pathological staging and the selection of treatment modalities.