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Influence of educational background in pathological stage and treatment modalities in Iranian breast cancer patients: A retrospective single-center study

Background: Breast cancer (BC) is the most frequently diagnosed visceral cancer, with 13,400 new cases annually in Iranian women. A few studies in Western countries have indicated that BC patients with higher educational backgrounds have a better prognosis than patients with lower educational backgrounds. In a retrospective single-center study, we examined educational background and its relationship with pathological stage and treatment modalities in 3010 BC patients. Materials and Methods: The medical records of the patients from the database at the Cancer Research Center of the Shahid Beheshti University of Medical Sciences were reviewed. Univariate logistic regression analysis was used to link educational background to pathological BC stage and treatment modalities. Results: The average age at diagnosis was 49.1 ± 11.6 years. Regarding education level, 4.2% of the patients were illiterate, 7.8% had primary school level education, 7.5% had middle school level education, 21.8% had secondary school and diploma level education, 18.6% had university level education and higher, and 40.1% had unspecified level education. Based on the univariate logistic regression analysis, the illiterate group had 65.1% of early-stage BC (Stages I and II) and the university level education and higher group had 73.4% of early-stage BC (P < 0.001). The rate of receiving chemotherapy, radiotherapy, and endocrine therapy was 35.7%, 42.1%, and 50% in the illiterate group and 93.7%, 64.3%, and 71.1% in the university level education and higher group, respectively (P < 0.001). Moreover, the rate of breast-conserving surgery was 15.1%, 18%, 16.3%, 42.5%, and 73.2% in the illiterate, primary school level education, middle school level education, secondary school and diploma level education, and university level education and higher groups, respectively (P < 0.001). Conclusion: The study's findings showed that educational background had a signiﬁcant impact on pathological staging and the selection of treatment modalities.