A. Morito Aguilar (Majadahonda, Spain)

Hospital Universitario Puerta de Hierro - (INSALUD)

Author Of 2 Presentations

 On-Demand ePoster Display

133P - Breast Cancer in Young Women (BCYW). Different entity or different needs?

Abstract

Background

Breast cancer is the most common cause of cancer-related deaths in women under 45 years. It has been reported as a more aggressive disease, with worse survival and higher rate of late toxicities in long term survivors, but this population is underrepresented in studies. We designed a study with Real World Data (RWD) focusing on the BCYW population to fill a knowledge gap.

Methods

A retrospective observational study was conducted, including all patients younger than 46 years with a first consultation in the Breast Cancer Unit of the Puerta de Hierro University Hospital between 2009 and 2019. Epidemiological, clinical, pathological and treatment information was collected. We aim to understand the characteristics of our BCYW population with RWD from over a decade of breast cancer care.

Results

559 patients with diagnostic of invasive breast cancer were included. Median age was 41 years (IQR 38 - 44). Population was divided into 3 groups for a better understanding. Patients with previous pregnancy are fewer in the younger subgroup (p<0.000), suggesting the need of fertility counselling. An association is observed between age subgroups and chemotherapy treatment, more likely in the younger subgroup (p=0.008). In <35 years, less stage I, more nodal involvement, triple negative subtype and more mastectomies were described, but without observing any significant association between these and other variables

< 35 years % 35 - <40 years% >= 40 years% All%
n (%) 55 (9,9%) 146 (26,1%) 358 (64%) 559
Pregnancy 59,3 74,1 83,3 78,6
ACO 45,6 33,6% 43 40,8
IMC median (IQR) 21,9 (19,8 – 23,6) 22,6 (20,4 – 24,6) 23,1 (21,2 – 26,6) 22,8 (20,8 – 25,8)
AF breast cancer 34,6 35,6 34,6 34,9
BRCA1/2 positive 10,9 6,2 4,8 5,7
Ductal 90,9 87,7 81,8 84,2
Lobular 5,5 4,8 10,9 8,8
Others 3,6 7,5 7,3 7
I 20 31 36,8 33,6
II 52,7 43,5 37,1 40,3
III 25,5 20 21,1 21,2
IV 1,8 5,5 5 4,9
Nodal involvement + 60 48,6 48,3 49,6
TN 18,5 9,1 11,6 11,6
RRHH+ HER2- 59,3 74,1 72 71,3
RRHH+ HER2+ 18,5 11,2 11,9 12,4
RRHH- HER2+ 3,7 5,6 4,5 4,7
QT (total) 88,9 74,8 69,1 72,6
NEO-QT 32,7 25,3 23,7 25
Mastectomy 79,6 71,7 67,7 70
.

Conclusions

Globally, our BCYW cohort shows a subtype and stage distribution similar to that expected in the general population described in historical records. Although no association was found between the different age groups and most of the clinical or pathological characteristics, the data described for stage I, lymph node involvement, triple negative breast cancer, BRCA mutations and mastectomies in the younger group justify future and deeper research in larger cohorts. We can´t conclude that BCYW is a different entity, but we agree with the mayor consensus that BCYW have different needs and should be studied.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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174P - Breast screening at young age. A real need?

Abstract

Background

Screening mammography are stablished between the age of 50-69 years in most countries with a few exceptions in those patients with a higher risk (BRCA, Family background…). Breast cancer in patients under 45 is about 15% of all new diagnosis. The clinical impact of treatment is often significant in this particular vulnerable population.

Methods

A retrospective observational study of young breast cancer patients (YBCP ≤45 years old) diagnosed between 2009-2019 in HUPHM was carried out. The main objective was to explore difference between asymptomatic patients (screening) versus symptomatic patients (lump, swelling, pain…). Epidemiological, clinical, pathologic and treatment information was collected.

Results

We analyzed 590 young patients (≤ 45 years old) with a new diagnosis of in situ or infiltrating breast cancer. Results are summarized in the table below.

Asymptomatic Symptomatic univariate analysis, p
N (%) 162 (27%) 428 (73%)
Median age/range 41,9 (26-45) 41,2 (28-45)
Stage 0 (in situ) 20% 5% p=0.001
Stage I 46% 30% p=0.001
Stage II 25% 40% p=0.001
Stage III 6% 20% p=0.001
Stage IV 3% 5% p=0.01
Family background 40% 32% p=0.091
BRCA 1/2 8% 5% p=0.14
Lymph node positive 24% 45% p=0.0001
Mastectomy/Breast conservative 64%/36% 72%/28% p=0.1
Neoadyuvant CT 13% 30% p=0.0001
CT neo or adyuvant 54% 79% p=0.0001
Radiotherapy 31% 54% p=0.0001
Relapse 11% 17% p=0.02

Conclusions

Most women under 45 years are diagnosed with breast cancer due to symptoms, since they are excluded from screening programs. No differences were found in family background between the two groups. Women who are screened are diagnosed with a statistically significantly lower stage, less lymph node involvement, receive less chemotherapy, less radiotherapy, and have fewer relapses. Screening programs in young patients could avoid some of the treatments and related late side effects.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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