Breast Cancer in Young Women Presents With More Aggressive Pathologic Characteristics: Retrospective Analysis From an Argentine National Database

Abstract

PURPOSE Multiple studies have reported that breast cancer in young patients is associated with aggressive characteristics, and it is suggested that prognosis is worse independently of pathologic variables. PATIENTS AND METHODS We performed a retrospective analysis of the Breast Cancer Registry of the Argentinian Society of Mastology, including public and private centers. Patients ≤ 40 years of age at diagnosis were classified as “young,” and patients ≤ 35 years of age at diagnosis were classified as “very young.” Univariate and multivariate analyses were performed to detect differences between groups. RESULTS Patients ≤ 40 years of age comprised 10.40% (739/7,105) of the participants, with an average age of 35.61 ± 4.04 years. Multivariate analysis showed that human epidermal growth factor receptor 2 (HER2)-positive tumor phenotype (odds ratio [OR], 1.82), nodal involvement (OR, 1.69), histologic grade (grade 3 OR, 1.41), and tumor size (T2 OR, 1.37; T3-T4, 1.47) were independently associated with younger age at diagnosis. Patients ≤ 35 years of age (n = 286), compared with patients 36 to 40 years of age, had a higher proportion of HER2 tumors (24.58% v 16.94%; P = .021), absence of progesterone receptor expression (29.85% v 22.95%; P = .043), and stage 3 cancer (29.34% v 18.52%; P < .001). Fewer breast-conserving surgeries (75.37% v 62.89%; P < .001) and more adjuvant chemotherapy (59.04% v 36.66%; P < 0.001) were reported in patients ≤ 40 years of age. CONCLUSION In the population studied, breast cancer in young women was associated with aggressive pathologic features and locally advanced disease at the time of diagnosis. Moreover, tumor characteristics in very young patients with breast cancer nested in the population ≤ 40 years of age showed differences in important prognostic factors. More high-quality evidence is needed to improve treatment strategies in these patients.

Cancer Statistics in Kurdistan Region of Iraq: A Tale of Two Cities

“…Among adolescents in the present study, lymphomas and CNS tumours vs lymphomas and soft tissue cancers were the second and third most common cancers in Erbil and Duhok, respectively. In Iraq as a whole, CNS cancers and lymphomas were the second and third most common cancers 2 Finally, breast cancer is rare under the age of 20 years in women 51 , and the current study a rmed this, but the small incidence of breast cancer reported among this age group was more aggressive than in older patients 52 / Young age is an independent poor prognostic factor in breast cancer 53 . Hence, it is important to take breast cancer screening programs at an earlier age into consideration.…”

Pregnancy-associated breast cancer: nationwide Dutch study confirms a discriminatory aggressive histopathologic profile

“…Our findings in this large nationwide cohort of PABC patients add to the existing literature, implicating that PABC may be a different breast cancer entity than breast cancer in non-pregnant young women. Although a more aggressive histopathologic profile is observed in young breast cancer patients in general [ 16 , 26 – 28 ], PABC patients show an even more aggressive histopathologic profile. These findings render interesting clues for further studies to unravel the molecular and genetic background of PABC.…”

Epidemiological Analyses Reveal a High Incidence of Breast Cancer in Young Women in Brazil

“…Another point we would like to address is the higher incidence of breast cancer among young women in Brazil than in the United States, which is also supported by reports from Brazil and from other developing countries. 27 , 34 , 35 Differences in disease incidence among young individuals may be attributable not only to inherited genetic factors but also to modifiable risk factors, such as smoking and alcohol, and the exposure to carcinogens. Although the etiological factors responsible for such differences are unknown, 17 , 27 the chronic exposure to endocrine disrupting and carcinogenic pesticides may be a concern.…”