Breast cancer is the most frequent cancer diagnosed in adult young women in Europe. Although rare (<5% before 35 years), it is one of the leading causes of death in this age group. The aim of this study is to characterize a cohort of young women regarding incidence, tumor stage, biology, treatment and survival.
We present a retrospective multi-center study of women less than 35 years old, diagnosed with breast cancer between 2008 and 2017. A total of 207 patients from 5 centers were included. Thirty five were excluded: 27 due to lack of data, 1 due to two different synchronous tumors and 7 had ductal in situ carcinoma. Data was analyzed using IBM SPPS statistics.
Median age was 31 years and ductal invasive carcinoma was the most frequent histologic subtype (91%). In the analysis of tumor subtype: 4% of tumors were luminal A, 20% luminal B HER2 positive, 47% luminal B HER2 negative, 8% HER2 positive (hormone receptor negative) and 20% triple negative. Forty eight percent of patients were diagnosed with early breast cancer, 45% were locally advanced and 6% had de novo metastatic cancer. Thirty nine percent of patients were treated with neoadjuvant chemotherapy (CT) and pathological complete response was obtained in 12%. Eighty three percent of patients were treated with adjuvant systemic therapy (CT or endocrine therapy), 18% exclusively with endocrine therapy. The median follow-up time was 53,5 months. Metastatic disease developed in 37 patients: 7 patients with bone metastasis only, 17 with both bone and visceral metastasis and 14 patients with central nervous system in addition to bone and visceral disease. The median survival of metastatic patients was 16,5 months. Local recurrence occurred in 3 patients with a median time of 27 months. Eighty five percent of these women are alive.
As expected, frequency of HER2 positive and triple negative tumors is increased in this age group, and the frequency of locally advanced and de novo metastatic disease is more prevalent. The median survival of metastatic patients is low in this age group as is the median survival. Due to more aggressive biology, initial staging and survival, the group of very young women with breast cancer deserves special treatment approaches.
Inês Fernandes Eiriz.
Has not received any funding.
All authors have declared no conflicts of interest.