Breast Cancer under 40 Years of Age: Increasing Number and Worse Prognosis

Dobi, Ágnes; Kelemen, Gyöngyi; Kaizer, László; Weiczner, Roland; Tamás, László; Kahán, Zsuzsanna

doi:10.1007/s12253-010-9305-3

Cited by 19 publications

(19 citation statements)

References 15 publications

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“…Many studies showed that as the age increases the tumors tends to be less aggressive with low rate of lymph node metastasis, low clinical stage and high levels of ER and PR expression. In younger patients, the tumors tend to be of unfavorable histological features with low receptor status [24]. Another study showed the age of 80 years and above to have more favorable histological features[25], this findings are also seen in our study where patients below 46 years of age had high rate of lymph node metastasis (p = 0.012)…”

Section: Discussionsupporting

confidence: 84%

Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study

et al. 2011

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BackgroundBreast cancer is more common in Western Countries compared to African populations. However in African population, it appears that the disease tends to be more aggressive and occurring at a relatively young age at the time of presentation. The aim of this study was to describe the trend of Breast Cancer in Northwestern Tanzania.MethodsThis was a retrospective study which involved all cases of breast cancer diagnosed histologically at Bugando Medical Center from 2002 to 2010. Histological results and slides were retrieved from the records in the Pathology department, clinical information and demographic data for patients were retrieved from surgical wards and department of medical records. Histology slides were re-evaluated for the histological type, grade (By modified Bloom-Richardson score), and presence of necrosis and skin involvement. Data was entered and analyzed by SPSS computer software version 15.FindingsThere were 328 patients histologically confirmed to have breast cancer, the mean age at diagnosis was 48.7 years (+/- 13.1). About half of the patients (52.4%) were below 46 years of age, and this group of patients had significantly higher tendency for lymph node metastasis (p = 0.012). The tumor size ranged from 1 cm to 18 cm in diameter with average (mean) of 5.5 cm (+/- 2.5), and median size of 6 cm. Size of the tumor (above 6 cm in diameter) and presence of necrosis within the tumor was significantly associated with high rate of lymph node metastasis (p = 0.000). Of all patients, 64% were at clinical stage III (specifically IIIB) and 70.4% had lymph node metastasis at the time of diagnosis. Only 4.3% of the patients were in clinical stage I at the time of diagnosis. Majority of the patients had invasive ductal carcinoma (91.5%) followed by mucinous carcinoma (5.2%), Invasive lobular carcinoma (3%) and in situ ductal carcinoma (0.3%). In all patients, 185 (56.4%) had tumor with histological grade 3.ConclusionBreast cancer in this region show a trend towards relative young age at diagnosis with advanced stage at diagnosis and high rate of lymph node metastasis. Poor Referral system, lack of screening programs and natural aggressive biological behavior of tumor may contribute to advanced disease at the time of diagnosis.

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Section: Discussionsupporting

confidence: 84%

Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study

et al. 2011

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“…This may be due to poor breast cancer screening in young women, as the incidence of the disease in this population is low, which results in patients having larger masses and more advanced disease when they are diagnosed. Additionally, younger patients were more likely to be hormone receptor-negative, and elderly patients were more likely to be hormone receptor-positive, findings consistent with those of many studies[4, 6, 8, 9, 22]. In most studies, factors such as disease stage, grade, and hormone receptor status were classical predictors of breast cancer survival[5, 23, 24].…”

Section: Discussionsupporting

confidence: 81%

“…In addition, previous studies also determined that young patients were more likely to have HER2-positive disease[4, 22]. However, HER2 status was not documented in the SEER database before 2010; therefore, we did not include this variable in our analysis, but it should be included in future analyses.…”

Section: Discussionmentioning

confidence: 99%

“…Age is an important risk factor for breast cancer, as women over 50 years of age accounted for approximately 78% of new breast cancer cases and 87% of breast cancer-related deaths in 2011 in the United States[2]; however, the worldwide incidence of breast cancer among younger women has increased[3, 4] such that breast cancer is the most frequently diagnosed form of cancer among women aged <40 years[5]. Therefore, it is very important to understand the association between age at diagnosis and breast cancer survival.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database

et al. 2016

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BackgroundAge is an important risk factor for breast cancer, but data regarding whether patient age at diagnosis is related to breast cancer survival are conflicting. This population-based study evaluated the effect of age on breast cancer prognosis and identified outcome-related factors.Patients and MethodsWe searched the Surveillance, Epidemiology, and End Results (SEER) database and enrolled female primary non-metastatic cases. Patients were subdivided into seven groups, and analyses of the associations between age and overall survival (OS) and breast cancer-specific survival (BCSS) were carried out using the Kaplan-Meier method and Cox regression model, respectively. We also assessed differences in survival among three specific age groups, using the ages of 30 and 50 years as cut-offs. Stratified analyses regarding race, histology, grade, stage and hormone receptor status were also carried out.ResultsA total of 133,057 female patients diagnosed with breast cancer from 2004 to 2008 were included in the current study (6.4% <40 years), Women aged 40 to 49 years and 60 to 69 years exhibited significantly better OS and BCSS, respectively (log-rank, p<0.001), than their counterparts in other groups. Middle-aged women exhibited distinctly better OS (log-rank, p<0.001) and BCSS (log-rank, p<0.001) than their counterparts in the other two age groups. Following adjustments for potential confounding factors, middle-age at breast cancer diagnosis was shown to be an independent predictor of favourable outcomes in terms of OS, but not BCSS (for OS, HR, 0.92; 95%CI, 0.87–0.98; p = 0.007; for BCSS, HR, 0.94; 95%CI, 0.80–1.01; p = 0.075, using the young group as reference). Stratified analysis showed that middle-age was significantly associated with increased survival, except among patients with stage III disease, and that elderly women faced worse prognoses than younger patients.ConclusionOur results indicate that younger breast cancer patients exhibit more aggressive disease than older patients. Middle-aged patients exhibit better OS and BCSS than young and elderly patients but exhibit BCSS rates similar to those of young patients after adjustments for confounders. Stratified analysis demonstrated that middle-aged patients exhibited better survival than young patients, with the exception of patients with stage III disease. An age of 60 years or more was a significant independent predictor of a poor prognosis.

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“…About 14 to 20 percentages of breast cancers are triple negative (Carey et al, 2006;Hannemann et al, 2006;Lund et al, 2010). Similar to our study, the significant increase of the triple negative tumors with decrease of cancer onset age has been shown in many other studies in different countries that TNBC has been more frequent in younger ages (Dobi et al, 2011;Salami et al, 2011).…”

Section: Discussionsupporting

confidence: 91%

Familial Breast Cancer Registry Program in Patients Referred to the Cancer Institute of Iran

Sabokbar

Khajeh²,

Taghdiri³

et al. 2012

Asian Pacific Journal of Cancer Prevention

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Introduction: Annually a considerable number of people die because of breast cancer, a common disease among women also in Iran. Identifying risk factors and susceptible people can lead to prevention or at least early diagnosis. Among susceptibility risks, 5-10% of patients have a family history predisposing factor which can influence the risk of incidence among the family. Having a registry program can be a more practical way to screen high risk families for preventive planning. Method: Based on inclusion criteria, a questionnaire was prepared and after a pilot study on a small number of patients, actual data were collected on 400 patients and processed in SPSS 16.0. Results: Totally, 28.2%of the patients were younger than 40 years old and 36.8% had the included criteria for familial breast cancer (FBC). 102 patient's samples could be compared for receptor presentation. Similar to other studies, the number of triple negative breast cancers increased as the age decreased. Conclusion: The high percentage of patients with FBC among 400 cases in this study demonstrates that in order to design an infrastructural diagnostic protocol and screening of patients with FBC, a precise survey related to frequency and founder mutations of FBC is needed nationwide.

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Breast Cancer under 40 Years of Age: Increasing Number and Worse Prognosis

Cited by 19 publications

References 15 publications

Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study

Pathological features of Breast Cancer seen in Northwestern Tanzania: a nine years retrospective study

Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database

Familial Breast Cancer Registry Program in Patients Referred to the Cancer Institute of Iran

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