Clinicopathological Features, Prognostic Factors, and Treatment Outcomes in Non-metastatic Breast Cancer in Young Asian Women in Hong Kong

• Published in: Hong Kong journal of radiology : HKJR = Xianggang fang she ke yi xue za zhi Vol. 25; no. 2; pp. 103 - 112
• Main Authors: Chung, HS, Chow, JCH, Lam, MHC, Ngan, RKC, Wong, KH
• Format: Journal Article
• Language: English
• Published: Hong Kong Hong Kong Academy of Medicine 01.06.2022
• Subjects: Age; Biopsy; Breast cancer; Cancer therapies; Chemotherapy; Ethnicity; Gene expression; Lymphatic system; Medical prognosis; Metastasis; Mutation; Population; Radiation therapy; Surgery; Tumors; Womens health; Hong Kong
• ISSN: 2223-6619; 2307-4620
• DOI: 10.12809/hkjr2217419

Objectives Breast cancer is the leading cause of death in young women (<40 years) and is a distinct entity. We reviewed the clinicopathological features and survival outcomes of young females with breast cancer in Hong Kong. Methods We performed a retrospective study of 497 women <40 years with non-metastatic breast cancer from a single institution in Hong Kong from 2005 to 2013, analysing clinicopathological, prognostic, survival, and treatment data. Results Median age at diagnosis was 36 years. The majority of patients (87.7%) had invasive ductal carcinoma. Grade III tumours composed approximately 40%. Proportions of stage I, II and III diseases were 34.8%, 46.1%, and 18.1%, respectively. Hormone receptor status was positive in 80.7%; human epidermal growth factor receptor 2 status was positive in 27.2%. In all, 53.7% underwent mastectomy while 46.3% received breast-conserving surgery. In total, 85.1% had neoadjuvant and/or adjuvant chemotherapy. Adjuvant radiotherapy was delivered in 78.5% and hormonal therapy was given in 73.4%. Over a 9.1-year median follow-up, 26% developed recurrence and 16.1% died. The 5-year and 10-year disease-free survival were 82.1% and 74.3%, respectively. The 5-year and 10-year overall survival were 90.5% and 83.5%, respectively. Nodal stage was the only independent prognostic factor for disease-free survival and overall survival. Conclusion Breast cancer in young patients tended to have aggressive features and presented at an advanced stage. Breast cancer in young Asian women may have distinct phenotypes with more hormone-positive disease compared to Western patients and warrants further investigations. Improved survival may be achieved with multimodality treatments.