Title : Breast cancer in very young women (less than 30 years): Demographics, treatment and prognosis
Background: Breast cancer diagnosed at younger age has aggressive biology being triple negative and high grade and associated with poor prognosis.
Patients and Methods: Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 was reviewed. Data was extracted from the cancer registry department of the institute. Demographics studied were age at diagnosis, gender, pregnancy or lactation associated, family history, histopathological diagnosis, stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, and survival.
Results: Only single patient was male. Age range was from 20 -30 years, only a single patient had bilateral involvement. Almost half 50.4%(n=61) patients had locally advanced disease at presentation. Pregnancy/ lactation associated breast cancer was seen in 29.8%(n=36). Most common stage was stage III (52.1%) & stage II (33.9%). Invasive ductal carcinoma was the most common histology 94.2% (n=114) patients, Triple negative was the most common molecular subtype present in 46.3%(56). Chemotherapy was received by 92.6%(n=112), 88.4%(n=107)patients received radiation therapy to the breast & supraclavicular field . Modified radical mastectomy was performed in 57%(n=69) , breast conservation surgery in 35.5%(n=43), after 5 years follow up ,local recurrence was observed in 12.4%(n=15) , cancer related deaths were 42.1%(n=51).
Conclusions: Breast cancer in very young has very aggressive tumor biology , needs aggressive treatment with surgery , chemotherapy, radiation therapy and hormonal therapy, furthermore there is need to identify possible environmental factors which may contribute in the rising incidence in this age group.
1. The Presentation purpose is to highlight the demographic features, and the poor prognosis of breast cancer in this particular age group as the disease is aggressive, we also need to explore the role of environmental factors as the documented risk factors in the literature are lower in our subset of study population.
2. To highlight the psychosocial issues of these women, and fertility preservation specially in a developing country like Pakistan where there is lack of specialized breast cancer centers.