Breast cancer in young women less than 30 years from southern India: Study on clinical profile and outcome

Abstract

e22196 Background: Breast cancer in young patients have an aggressive behaviour with poorer outcome. The patients are in their reproductive age group and are concerned with fertility issues,pregnancy and lactation. The literature pertaining to patients less than 30 years is limited. Methods: 213 Patients under the age of 30 years with breast cancer were studied for Demographics, clinical presentations, pathological profiles, treatment and survival. The case records were retrospectively analyzed between Jan 1993 - Dec 2003 at Cancer Institute (WIA) Chennai. Results: The mean age of the study population was 28 years and ranged between 17 to 30 years. Early menarche, defined as less than 12 years (17.5 %), Nulliparity (21.1%), first child birth less than 18 years (26.8%) were the major risk factors noted. Family history of breast and ovarian cases were seen in 6.6% of the patients. The Stage distribution included Stage I (1.4%), Stage II (31%), Stage III (49.6) and Stage IV (11%) and unclassifiable (7%). Node positive tumours constituted 158 patients (74.1%). Hormone receptor studies were negative in 62% of the patients. Modified radical mastectomy was performed in 164 (77%) of the patients. Non infiltratring ductal carcinoma histopathology was noted in 13.6%. Surgical and radiocastration was performed in 35.2% and 17% of the cases respectively. Of 201 (94.3%) patients who received chemotherapy anthracycline based chemotherapy was delivered in 30.3%. Recurrence pattern included local, local and distant and distant recuurences in 8.5%, 23.5% and 2.3% respectively. The 5 year over all survival for the evaluable patients was 53.2%. Conclusions: Very young Indian patients less than 30 years constitute a unique subset of breast cancer patients with majority being hormone receptor negative and locally advanced stage at presentation. The over all outcome is inferior compared to older patients with breast cancer. More aggressive adjuvant treatment may help in improving survival. No significant financial relationships to disclose.