Biological Behavior and Evolutive Prognosis Amongst Young and Elderly Women Affected by Breast Carcinoma by Using Tissue Markers

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Breast Cancer (BC), in young women (i.e., up to 40 years old), is considered to be an aggressive illness, of difficult early diagnosis and high morbimortality rates. This aggressive biological behavior of BC in young women is related to BRCA1 mutation, whereas BRCA2 mutation occurs more frequently during pregnancy. Only 2% of women over 70 years old are at risk of BC, and some genic mutations are related to chronologic age. The delay of elderly women with BC to seek health service is associated with their responsibility to take care of their relatives neglecting them selves, fear and denial of cancer, ignorance of breast neoplasia and lack of resources in order to have access to health service. Women above 70 usually have heart, lung or vascular diseases, which can limit treatment. We intend to analyze tumor fragments in young women (up to 40 years old) and elderly women (above 70 years old) using the Tissue Microarray (TMA) technique, processing them by immunohistochemistry in order to evaluate biological behavior and hormone receptors. Material and Method: transversal study, from 2002 to 2008, based on the revision of medical records and tissue fragments of 32 women between 26 and 40 years old, and 63 women older than 70 years affected by Invasive Ductal Carcinoma (IDC), treated at Santa Casa Hospital in Sao Paulo, Brazil. Tumor fragments were marked, processed using the TMA technique, and immunohistochemistry reactions were processed for receptors of estrogen, progesterone, CerbB2 and Ki67. RESULTS: Tumors in young women were aggressive (T2 to T4), with high histological and nuclear levels. 63% showed impaired axillary lymph nodes, 52% were positive for hormone receptors and 2,5% were triple negatives. In elderly women, the most frequent staging was T2 with non-circumscript tumors. The most frequent immunohistochemical profiles were luminal A and B. Overexpression of HER2 occurred in 16,5% of the cases. CONCLUSION: Biological behavior of BC in young women shows an aggressive profile, high histological levels, and numerous lymph nodes metastasis, although 52% of the patients showed positive hormone receptors. In elderly women, the results indicate intrinsic differences in BC tumors in this age group, characterized by less aggressive morphological and immunohistochemical profiles.