Breast cancer in young women is generally considered to carry a worse prognosis. 50% of our patients (pts) are below the age of 50. We looked at our young patients age <40 years (y) with breast cancer at the American University of Beirut, assessed stages, characteristics and outcome.
Data on breast cancer in young pts seen at our institution between the years 2005 to 2018 was reviewed. Survival was calculated from date of diagnosis till recurrence, death, or last follow up. IRB approval was obtained.
Total number of pts ≤ 40 was 345. Over 300 pts had complete survival data. The median age at diagnosis was 36 years, IDC was present in 94.5% of cases, ILC in 1.2% of cases, and DCIS in 4.3%. Grade 1 disease was present in 8.9% of pts, grade 2 in 36.0%, grade 3 in 55.1%. HER2 positive pts in 28.9%, hormone receptor positive (ER &/or PR) in 75.9%, and 14.8% had triple negative breast cancer (TNBC). 58.2% of pts with Early Breast Cancer (EBC) had a partial mastectomy while 41.8% had a total mastectomy. 45.8% of all pts received adjuvant chemotherapy and 26.5% received neoadjuvant therapy (chemotherapy with or without anti-HER2 therapy). All hormone receptor positive pts received adjuvant hormonal therapy. 53.7% had EBC (stage I, IIA, IIB subset T2N1M0) while 26.7% had Locally Advanced (LABC): IIB subset T3N0M0, IIIA & IIIB. 14.0% had metastatic cancer at diagnosis and 11.2% of pts developed recurrent metastatic disease while 23.2% had metastatic de novo or recurrent disease. Overall Survival (OS) of pts with early stage was 97.8% at 5 years (y) and 77.5% at 10y; OS of pts with LABC was 91.3% at 5y and 73.7% at 10y. OS of pts with de novo MBC was 58.3% at 5y and 43.7% at 10y. OS of pts with recurrent metastatic disease was 70.3% at 5y and 35.6% at 10y while 5y survival of metastatic de novo or recurrent metastatic disease combined is 63.5% and 34.5% at 10 yr.
Prognosis of breast cancer in young women is improved with modern management that includes neoadjuvant therapy, surgery (that included 60% with partial mastectomy), radiation, targeted and adjuvant therapy according to their tumor characteristics, and stage. Young women with breast cancer can be reassured that their age does not mean they have a bad outcome. Biology and tumor characteristics and modern management determine outcome.
American University of Beirut Medical Center.
Has not received any funding.
All authors have declared no conflicts of interest.