Descriptive Study of Breast cancer in Women less than 40
Mahmoud T. Elsabah1, Abouelatta KH Ali2, and Mohamed M. Abdelhakim3
Departments of 1Pathology and 2Surgery, Faculty of Medicine, Misr University for Science &Technology. 6th of October city, Egypt and 3Radiation Oncology, National Cancer Institute, Cairo University, Egypt.
Background: Breast cancer is the most frequently diagnosed cancer in women. It is strongly believed that breast cancer in young women is characterized by a relatively unfavorable prognosis and unusual pathological features.
Aim of the work: Careful study of 50 premenopausal women diagnosed as invasive breast carcinoma with deep insight at clinico-pathological criteria and treatment strategies clarifying their impact on prognosis of those young females.
Patients: Fifty young female patients from menarche to the age of 40 were diagnosed as invasive breast carcinoma. Their clinical, radiological, methods of biopsy taking, histopathological criteria and treatment protocols were collected and analyzed.
Results: Breast feeders were 80% of the patients while the oral contraceptive users were 43%. Family history was negative in 90% of the patients and palpable swelling was the major clinical presentation (92%). Invasive duct carcinoma was the most common histological type (92%), histological grades (II-III) were recorded in 80% of the patients and pathological stages (II-III) were represented by 76% of examined cases. Moreover, 44% were ER+, 50 % were PR+, 30 % overexpressed Her2neu and 38% were triple negative. The surgical procedures were MRM in 59% of the patients, while 41% were managed by BCS with 11.7% local recurrences.
Conclusion: Breast feeding and oral contraceptives should be thoroughly reinvestigated as risk factors of breast cancer in young women. Tumor pathology such as higher tumor grade and stage contribute to the worse outcome in breast cancer in young women. Moreover, the percentage of the known aggressive triple negative tumors was high in young patients. Finally, young women carried the risk of local recurrence after BCS.