M. Engineer (Mumbai, India)
Tata Memorial Hospital - Tata Memorial CentreAuthor Of 1 Presentation
- J. Bajpai (Mumbai, India)
- V. Pradeep (Mumbai, India)
- R. Nandhana (Mumbai, An, India)
- S. Mohanty (Mumbai, India)
- Q. Chougle (Mumbai, India)
- M. Engineer (Mumbai, India)
- S. Rath (Mumbai, India)
- S. Joshi (Mumbai, India)
- T. Wadasadawala (Mumbai, India)
- P. Popat (Mumbai, India)
- R. Pathak (Mumbai, India)
- S. Gulia (Mumbai, India)
- J. Ghosh (Mumbai, India)
- P. Bhargava (Mumbai, India)
- S. Srinivas (Mumbai, India)
- T. Shet (Mumbai, India)
- R. Sarin (Mumbai, India)
- R. Badwe (Mumbai, India)
- S. Gupta (Mumbai, India)
162P - Unique challenges and Outcomes of Young Breast Cancers from a tertiary care cancer centre in India
Abstract
Background
Young (≤40 years) breast cancers (YBC) are relatively rare, have unique concerns (including outcomes, quality of life (QOL) and fertility) and merit adequate exploration.
Methods
The prospective data was collected for patients registered in 2015-2016.
Results
There were 1228 patients; median age was 36 (12-40) years; 40(3.3%) had Stage I, 486(39.6%)- II, 659(53.7%) -III, and remaining 43(4%) Stage IV(oligo-metastatic) disease; 927(75.5%) were node positive. Among them, 422(34.4%) were Triple negative breast cancers (TNBC), 475 (38.7%) were hormone receptor positive (HR+)/Her2 negative, 174(14.2%) were HR+/Her2+, and 157(12.8%) were HR-/Her2+. Of 1103 surgically resected patients, 48.2% underwent breast conserving surgery and the remaining had mastectomy; 609 (49.6%) received neoadjuvant chemotherapy (NACT) and 147 (24.1%) had pathological complete response(pCR); 39.4% in TNBCs, 30.8% in Her2+ who received Trastuzumab with NACT, and 11.5% in HR+. At the median follow-up of 48(range:0-131) months, 384(23.1%) patients relapsed. For patients with Stage I, II, III and IV, the 3 year overall survival was 100%, 90.4%(87.7%-93.3%), 81.9%(78.7%-85.1%),70.1%(57.7%-85.3%) and event-free survival was 94.4%(87.0%-100.0%), 77.2%(73.4%-81.3%), 66.5%(62.8%-70.5%), and 43.1%(30.5%-60.8%) respectively. On multivariate analysis, TNBC and HR-/Her2+ subgroups had poorer survival compared to HR+ patients(p=0.0035). Patients ≤35 years(n=608) compared with patients 36-40 years (n=620), had a lower PR expression (38.4% vs 44%; p=0.048) and higher use of NACT (54.6% vs 46.3%, p=0.009). 104(8.5%) received fertility preservation predominantly with LHRH agonists. 18 highly motivated patients attempted and 7 of those had successful pregnancy outcomes. There were significant postmenopausal symptoms (predominantly hot flushes, mood swings and vaginal dryness) in 153(13%) patients.
Conclusions
The Indian YBC cohort is unique as the proportion is higher than developed world, they present with higher stage and aggressive biology; however, as the stage matched outcomes are comparable, awareness via national registry and early diagnosis is highly warranted. Menopausal symptoms and fertility issues are prevalent and demand specialised focus.
Legal entity responsible for the study
Tata Memorial Center.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.