Profiling young women with breast cancer

                     

Introduction: Currently, women under the age of 35 with breast cancer (BC) are treated in a similar manner to their peri/postmenopausal counterparts. In addition, similar risk factors such as family history, age of first pregnancy and BMI are used to determine an individual’s risk of developing BC.

Methods: The aim of this study was to evaluate subtypes, risk factors and outcomes in young women with breast cancer. A 10-year review of a prospectively maintained database was conducted to profile young women (35 years old or younger) with BC.

Results: A total of 86 patients were identified with ages ranging from 23 to 35 (mean age 32). The vast majority (88.3%) were invasive ductal carcinomas and of these 72% were luminal, 17% were triple negative for oestrogen, progesterone and Her-2, and 11% were Her-2 positive breast cancers. Only 41% had a positive family history of breast/ovarian cancer mastectomies were performed in 62% and 49% were axillary node positive. In terms of risk factors, 64% were previously pregnant, the average BMI was 25 and 70.4% reported previous OCP use. Overall mortality was 9.3% with a recurrence rate of 7% and distant metastatic rate of 3.5%.The frequency of BRCA 1/2 mutation identified in 13.4%.

Conclusion: Young women with BC have a similar biological subtype profile to their peri/postmenopausal counterparts however they present with more locally advanced disease. Hormonal risk profile differs significantly as pregnancy does not appear to provide any protective effect and OCP use appears to be a risk factor for BC in this young population. BRCA 1/2 mutation in our set of group somewhat higher than those reported.

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