Breast cancer in young women: A retrospective study from tertiary care center of north India

Abstract

Aim: Breast cancer is the most common cause of cancer in women worldwide. They have more aggressive clinical behaviour with poor outcomes in younger patients. The aim of this study was to evaluate the impact of age on prognosis of breast cancer in women above and under 40 years of age. Material and Methods: Medical record of 415 patients with invasive breast cancer were analysed from January 2011 to December 2014 in our department.The last was done in December 2015.All cases diagnosed with breast cancer stages I to IV were evaluated, and grouped on the basis of age [less than 40 and above 40 years].Baseline categorical variables were analysed using the Chi-square test or Fisher's exact test. Non categorical variable were analysed using t-test. Result: A total of 372 patients were reviewed because 42 patients defaulted. The median age at the time of diagnosis was 44.6 years (range 23 to 90 years).Metastasis to distant organs were more in women with age <40. Tumour relapse occurred in 131 cases, among which 84 cases died, 35 patients (26.31%) in less than 40 group vs.49 patients (20.50%) in above 40 groups. The estimated median OS in the two groups are 32 and 41 months respectively. Conclusion: The biological behaviour of breast cancer in younger age group has been shown to be associated with aggressive nature and has a worse clinical outcome as compared to that in older group.

Key words

Breast cancer - metastasis - poor prognosis - young age

• References

• 1 Brinton LA, Sherman ME, Carreon JD, Anderson WF. Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst 2008;100:1643-8.
• 2 Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol 2008;26:3324-30.
• 3 Colzani E, Liljegren A, Johansson AL, Adolfsson J, Hellborg H, Hall PF, et al. Prognosis of patients with breast cancer: Causes of death and effects of time since diagnosis, age, and tumor characteristics. J Clin Oncol 2011;29:4014-21.
• 4 Bharat A, Aft RL, Gao F, Margenthaler JA. Patient and tumor characteristics associated with increased mortality in young women (<or=40 years) with breast cancer. J Surg Oncol 2009;100:248-51.
• 5 Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 1996;78:1838-43.
• 6 Anders CK, Fan C, Par C, Parker JS. Breast carcinomas arising at a young age: Unique biology or a surrogate for aggressive intrinsic subtypes? J Clin Oncol 2011;29:e18-20.
• 7 Gajdos C, Tartter PI, Bleiweiss IJ, Bodian C, Brower ST. Stage 0 to stage III breast cancer in young women. J Am Coll Surg 2000;190:523-9.
• 8 Carvalho FM, Bacchi LM, Santos PP, Bacchi CE. Triple-negative breast carcinomas are a heterogeneous entity that differs between young and old patients. Clinics (Sao Paulo) 2010;65:1033-6.
• 9 Wapnir IL, Anderson SJ, Mamounas EP, Geyer CE Jr., Jeong JH, Tan-Chiu E, et al. Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in five National Surgical Adjuvant Breast and Bowel Project node-positive adjuvant breast cancer trials. J Clin Oncol 2006;24:2028-37.
• 10 Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA. Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. J Am Coll Surg 2009;208:341-7.