An institutional review of tumour biology of breast cancer in young Nepalese women

Bikash Nepal,Gita Sayami,Prakash Sayami,Yogendra Singh

doi:10.3126/jssn.v18i2.18569

Abstract

Introduction: Breast cancers in less than 40 years of age group usually present with aggressive biology and has poor prognosis. The aim of this study was to see clinic-pathological and hormone receptors of breast cancers in young women and compare with less than 40 year age group.Methods: Prospective analysis of 97 breast cancer in patients less than 40 years out of total 373 patients (26%) over a period of 8 years (2007 Jan to 2014 Dec) was carried out at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.Result: Among the young women diagnosed with breast cancer, the mean age was 34.5±6.2 years. Mean tumour size was larger in younger women (5±2.5 vs 4.5±2.4 cm). Locally advanced disease was higher in younger patients (55% vs 47%). Lymphatic and vascular invasions were higher (63% vs 35% and 40% vs 25%). Grade II and III tumours was higher (56% vs 25%). ER, PR and HER2 positivity was detected in 46.9%, 48.9% and 28.9% respectively. Significant lower ER or PR expression (34.5% vs 54%) was seen in younger women, p=.002.Triple negative tumours (ER -ve, PR -ve and HER2 -ve) was proportionately higher in younger patients (23% vs 13.7%, p=.043).Conclusion: Young Nepali women presents one quarter of all female breast cancers, more frequently locally advanced with aggressive tumour biology like ER/PR negative and triple negative breast cancers. Journal of Society of Surgeons of Nepal, 2015; 18 (2), page: 16-19

Highlights

Breast cancers in less than 40 years of age group usually present with aggressive biology and has poor prognosis
Diagnostic delay often occurs in young patient resulting advanced disease in initial presentation because of younger women themselves unaware of breast cancer and by physicians who are less suspicious of this disease in young patients[6]
Comparative analysis of patient demography, tumour characteristics and tumour biology were done between age

Summary

Introduction

Breast cancers in less than 40 years of age group usually present with aggressive biology and has poor prognosis. The aim of this study was to see clinic-pathological and hormone receptors of breast cancers in young women and compare with less than 40 year age group. Breast cancer is a heterogeneous group of tumour with variable morphology, behaviour, response to therapy, and molecular profile. Young women develop more aggressive subtypes of breast cancer[2]. Young age remains an independent risk factor for poor survival in breast cancer. Breast cancer incidence rate in young is low compared to elder population but it has unique biological features that are not observed in elder population[3]. Diagnostic delay often occurs in young patient resulting advanced disease in initial presentation because of younger women themselves unaware of breast cancer and by physicians who are less suspicious of this disease in young patients[6]

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Methods

Conclusion