Breast cancer in women younger than 35 years old

• Published in: Archives of gynecology and obstetrics Vol. 302; no. 3; pp. 721 - 730
• Main Authors: Zouzoulas, Dimitrios, Tsolakidis, Dimitrios, Gitas, Georgios, Zafrakas, Menelaos, Goulis, Dimitrios G., Douganiotis, George, Sympilidis, Georgios, Grimbizis, Grigorios
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020; Springer Nature B.V
• Subjects: Adult; Breast cancer; Breast Neoplasms - epidemiology; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Endocrinology; Female; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Lymphatic system; Medical prognosis; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Prognosis; Retrospective Studies; Survival Rate; Tumors; Womens health; Young Adult; Very young women; Breast cancer; Survival rates; Prognostic features
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-020-05695-z

Purpose Women ≤ 35 years old with breast cancer constitute a special group. Considering the impact of the disease and its prognosis, these patients face some specific problems that are not present in older women. What are the prognostic features of the survival rate in very young women with breast cancer? Methods Retrospective analysis of very young women with breast cancer from the Surgical-Oncologic Breast Cancer Department at “Theagenio” Anticancer Hospital, 2003–2016. Patient and tumor characteristics, treatment options and follow-up information were collected. Univariate–multivariate analyses were conducted and survival rates were calculated. Results The median age was 34 years old. 53 patients (41%) had T1, 36 (28%) had T2, 7 (5.4%) had T3 and 33 (25.6%) had T4 stage tumors. Most women, 114 (88.4%), had ductal carcinoma in their histology. Furthermore, positive axillary lymph nodes were present in 62 women (48%). In the immunochemistry report, 91 patients (70.5%) were hormone receptor positive, HER2 was overexpressed in 32 patients (24.8%) and 27 patients presented with triple-negative subtype. Out of 65 patients tested for Ki-67, 51 (78.5%), had a high expression (cut-off value of 20%). After adjusting for all possible factors, the risk of recurrence and death was six times higher in the positive lymph node group, ( p  < 0.001). The median disease-free and overall survival was 133 and > 173 months, respectively. Conclusion Breast cancer in very young women appears with large size and high-grade tumors, high incidence of infiltrated axillary lymph nodes, high Ki-67 expression and intrinsic subtypes with poor prognosis. As a result, these women need to be treated by a multidisciplinary team.