PROGNOSIS OF BREAST CANCER IN VERY YOUNG AGE (LESS THAN 30 YEARS)
Abstract
Purpose: Breast cancer diagnosed at a younger age has aggressive biology being triple negative and high grade and is associated with poor prognosis.
Materials and Methods: Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 were reviewed. Data were extracted from the cancer registry department of the institute. Demographics studied were the age at diagnosis, gender, pregnancy or lactation association, family history of breast cancer, histopathological diagnosis, and stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, and survival.
Results: A total of 121 patients with age 30 years or less were included. An only a single patient was male. The age range was from 20 to 30 years; bilateral involvement was seen in a single patient. Almost half 50.4% (n = 61) patients had locally advanced disease at presentation. Pregnancy/lactation-associated breast cancer was seen in 29.8% (n = 36). The most common stage was Stage III (52.1%) and Stage II (33.9%). Invasive ductal carcinoma was the most common histology 94.2% (n = 114) of patients; triple negative was the most common molecular subtype present in 46.3% (n = 56). Chemotherapy was received by 92.6% (n = 112), 88.4% (n = 107) patients received radiation therapy. Modi ed radical mastectomy was performed in 57% (n = 69), breast conservation surgery in 35.5% (n = 43), follow- up period was 5 years, local recurrence was observed in 12.4% (n = 15) and cancer related deaths were 42.1% (n = 51).
Conclusions: Breast cancer in very young has very aggressive tumour biology, needs aggressive treatment with surgery, chemotherapy, radiation therapy and hormonal therapy.
Key words: Breast cancer, pregnancy-associated aggressive tumour biology, triplenegative, young
References
Gelmon K, Partridge AH, Morrow M, et al. ASCO Educational Book 2005. Breast Cancer in Young Women: Epidemiology, Treatment, and Survivorship Issues. Alexandria, VA: American Society of Clinical Oncology; 2005. p. 61-7.
Fredholm H, Eaker S, Frisell J, et al. Breast cancer in young women: Poor survival despite intensive treatment. PLoS One 2009;4:e7695.
Kroman N, Jensen MB, Wohlfahrt J, et al. Factors in uencing the effect of age on prognosis in breast cancer: Population based study. BMJ 2000;320:474-8.
Xiong Q, Valero V, Kau V, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis: The M.D. Anderson cancer center experience. Cancer 2001;92:2523-8.
Han W, Kang SY, Korean Breast Cancer Society. Relationship between age at diagnosis and outcome of premenopausal breast cancer: Age less than 35 years is a reasonable cut-off for de ning young age-onset breast cancer. Breast Cancer Res Treat 2010;119:193-200.
Albain KS, Allred DC, Clark GM. Breast cancer outcome and predictors of outcome: Are there age differentials? J Natl Cancer Inst Monogr 1994;16:35-42.
Remvikos Y, Magdelenat H, Dutrillaux B. Genetic evolution of breast cancers. III: Age-dependent variations in the correlations between biological indicators of prognosis. Breast Cancer Res Treat 1995;34:25-33
Brinton LA, Sherman ME, Carreon JD, et al. Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst 2008;100:1643-8.
Walker RA, Lees E, Webb MB, et al. Breast carcinomas occurring in young women (< 35 years) are different. Br J Cancer 1996;74:1796-800.
Akarolo-Anthony SN, Ogundiran TO, Adebamowo CA. Emerging breast cancer epidemic: Evidence from Africa. Breast Cancer Res 2010;12 Suppl 4:S8.
Azim HA Jr., Michiels S, Bedard PL, et al. Elucidating prognosis and biology of breast cancer arising in young women using gene expression pro ling. Clin Cancer Res 2012; 18:1341-51.
Ministry of Health and Welfare. Annual Report of Cancer Statistics in Korea in 2011. Korea: Goyang Korea Central Cancer Registry; 2012.
Meshikhes AW, Al-Mubarek MA, Al-Tufaif AA. Breast cancer during pregnancy and lactation. Saudi Med J 2004; 25:531-2.
Asgeirsson KS. Pregnancy-associated breast cancer. Acta Obstet Gynecol Scand 2011;90:158-66.
Albrektsen G, Heuch I, Thoresen S, et al. Clinical stage of breast cancer by parity, age at birth, and time since birth: A progressive effect of pregnancy hormones? Cancer Epidemiol Biomark Prev 2006;15:65-9.
Johansson AL, Andersson TM, Hsieh CC, et al. Family history and risk of pregnancy-associated breast cancer (PABC). Breast Cancer Res Treat 2015;151:209-17.
Keegan TH, Press DJ, Tao L, et al. Impact of breast cancer subtypes on 3-year survival among adolescent and young adult women. Breast Cancer Res 2013;15:R95.
Tang LC, Jin X, Yang HY, et al. Luminal B subtype: A key factor for the worse prognosis of young breast cancer patients in China. BMC Cancer 2015;15:201.
Bayraktar S, Amendola L, Gutierrez-Barrera AM, et al. Clinicopathologic characteristics of breast cancer in BRCA- carriers and non-carriers in women 35 years of age or less. Breast 2014;23:770-4.
Zaharia M, Gómez H. Neoadjuvant chemotherapy in the treatment of locally advanced breast cancer. Rev Peru Med Exp Salud Publica 2013;30:73-8.
Cao JQ, Olson RA, Tyldesley SK. Comparison of recurrence and survival rates after breast-conserving therapy and mastectomy in young women with breast cancer. Curr Oncol 2013; 20:e593-601.
Bleyer A, Barr R, Hayes-Lattin B, et al. The distinctive biology of cancer in adolescents and young adults. Nat Rev Cancer 2008;8:288-98.
Brandt J, Garne JP, Tengrup I, et al. Age at diagnosis in relation to survival following breast cancer: A cohort study. World J Surg Oncol 2015;13:33.
Anders CK, Johnson R, Litton J, et al. Breast cancer before age 40 years. Semin Oncol 2009;36:237-49.
Assi HA, Khoury KE, Dbouk H, et al. Epidemiology and prognosis of breast cancer in young women. J Thorac Dis 2013; 5 Suppl 1:S2-8.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors retain copyright and grant the Journal of Cancer & Allied Specialties (JCAS) right-of-first publication. In addition, the work will be simultaneously licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license. This license allows others to share the work in whole or part (for non-commercial purpose), with an acknowledgement of the work’s authorship and initial publication in JCAS.
Furthermore, authors are free to enter into separate contractual arrangements for the non-exclusive distribution of the journal’s published version of the work, with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to share their work online or in medical or scientific conferences prior to or during submission process.
