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Abstract
BackgroundLiterature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries. BCYW is associated with delayed diagnosis, aggressive biology and poor prognosis. However, our knowledge of biological profile, treatment received and outcome of young patients is still limited in Morocco. We propose to analyze clinicopathologic, therapeutic and prognostic features of BCYW among a series of patients native and/or inhabitant of North of Morocco.MethodsWe carried out a retro-prospective study of 331 infiltrating breast cancer cases registered between January 2010 and December 2015. Details of tumor pathology, treatment and outcome were collected. Disease-Free Survival (DFS) and Overall Survival (OS) were assessed by Kaplan-Meier analysis.ResultsA total of 82 patients were diagnosed with breast cancer at the age of 40 or younger (24.8%). Median age was 36 years. More than one quarter (26%) of patients had family history of breast or ovarian cancer. Advanced stages accounted for 34.2% of cases. Median tumor diameter was 2.8 cm. Intermediate and high-grade tumors represented 47.6% and 40.2%, respectively. Nodal involvement was present in 58.5% and lymphovascular invasion was found in 47.7% of the patients. About two thirds (66.2%) of tumors were hormone receptor positive, 29.2% over-expressed HER2 receptor and 23% were triple negative. Patients underwent breast conserving surgery in 38.2% of cases, 61.7% were offered adjuvant chemotherapy and 84.6% received hormone therapy. Five-year DFS and OS were respectively 88.9% and 75.6%. Locoregional recurrence occurred in 2.8% of cases and 8.3% of patients developed distant metastases.ConclusionOur findings are in accordance with previous studies that have shown a higher frequency of breast cancer among Moroccan young women. In line with literature data, clinicopathologic profile seems to be aggressive and prognosis is pejorative in our series.
Highlights
Literature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries
We present a description of clinicopathologic, therapeutic and prognostic features among these south Mediterranean patients seen at the Oncology Clinic AL AMAL in Tangier, the only institution specialized in diagnosis and treatment of cancers available in the North Moroccan area at the beginning of the study
Hormone receptors (HR, Estrogen Estrogen receptor (ER) and Progesterone Progesterone receptor (PR)) expression was evaluated based on percentage of tumor cells nuclear staining by the immunohistochemical method (IHC)
Summary
Literature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries. Incidence rates are shown to be lower among young women and the peak is within the age range of 65–74 years in more developed countries [1]. Hospital-based series reported that breast cancer in young women (BCYW) do account for 8 to 25.4% [3,4,5,6], whereas this frequency does not exceed 7% in developed countries [7]. Young women deserve a particular attention because of the unique and complex challenges that these women are faced with [8] These breast cancer patients have to deal with many issues related to fertility, self-image, psychosocial distress and professional integration. Breast cancer in this age category tends to exhibit more aggressive features than that arising in Bakkach et al BMC Women's Health (2017) 17:106 older women [9,10,11,12,13,14], which makes the situation more difficult to handle
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