Breast Cancer In Young Females Research Articles

Association of Positive Family History and Clinicopathological Features in Breast Cancer in Young Indian Females – A Pilot Study

ABSTRACT Introduction: Breast cancer is the most common cancer in Indian females, accounting for 31.8% of all cancers. Young women with breast cancer are those under 40 years of age. These patients have higher chances of positive family history and genetic susceptibility. Approximately 5%–10% of cases of breast cancer are associated with a family history. In this study, we planned to identify a relationship between family history and the clinical, pathological, and genetic characteristics of breast cancer in young women. Methods: Retrospectively, data from patients aged < 40 years with breast cancer, were collected from 2019 to 2022. Detailed information about the family history of the patients including the degree and number of relatives affected and the types of cancer was recorded. The tumors were characterized based on the pathological grade, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 status, and BRCA variant genetic analysis. Results: Of 125 females with young breast cancer, 24 patients (19%) had a first- or second-degree relative with a history of cancer at the time of breast cancer diagnosis. Four (16%) of these positive cases had BRCA mutation detected. Bilateral breast cancer was detected in 12% of women with positive family history. Conclusion: Clinicians are urged to use detailed family histories for young women with breast cancer for early screening and education of the first- and second-degree relatives of these patients to detect the hidden cases.

Clinicopathological profile of breast cancer in young females at tertiary cancer center in Nepal

Background: Breast cancer is one of the commonest cancer in females globally. The scenario in Nepal is also similar. Breast cancers are now not only limited to older age group but younger females are also visiting hospital with breast malignancies. An increase in trend of breast cancer in young females have been noticed. They are reported to have a more aggressive clinical and pathological features. Material and methods: We conducted a retrospective study of breast cancers in mastectomy specimen with focus on young females of less than or equal to forty years of age. The data collection period was from January 1st to December 31st 2021. Data were collected from the records of department of pathology. All those cases of post neoadjuvant chemotherapy with no residual masses microscopically and cases of male breast carcinoma were excluded. Results: A total of 273 cases of mastectomies were analyzed. 75 cases were from patients of ≤40 years of age and 198 belonged to age group of >40 years. Invasive breast carcinoma of no special type and histological (Nottingham Histological score) grade of Grade 2 was common in both groups. However grade 3 was more prevalent in younger group. Left breast was most frequent laterality for the cancer. Perineural invasion was found more in older females. Conclusion: Breast cancer is no longer a disease of older females only. More and more cases are being diagnosed at younger age group and they are more aggressive in them. Hence there is a greater need to spread awareness regarding breast cancer in the younger population as well.

Pattern of Breast Cancer in Young Females in Minia Governorate.

Pattern of Breast Cancer in Young Females in Minia Governorate.

Knowledge, attitude, practice and factors that influence the awareness of college students with regards to breast cancer.

BACKGROUNDBreast cancer has the highest incidence of all global cancers. Recent data show that breast cancer is becoming more prevalent in the younger population. Therefore, preventing breast cancer in young populations is a significant priority for public health. Relevant investigations of the incidence of breast cancer in young females have already been undertaken in China; however, none of these previous studies investigated the awareness of female college students with regards to breast cancer.AIMTo investigate the knowledge, attitude, and practice (KAP) of female college students in Yunnan with regards to breast cancer and a series of influential factors. METHODSA random sample of 1387 female college students from two universities in Dali city were investigated by questionnaires.RESULTSThe total KAP scores for breast cancer were 9.86 ± 2.50, 3.19 ± 2.01 and 13.31 ± 2.49, respectively. Multiple linear regression analysis showed that educational grade was the most significant influential factor underlying the level of knowledge female college students had with regards to the treatment of breast cancer (P < 0.05). Registered residence and educational grade were the most significant factors that influenced attitude (P < 0.05). Age, registered residence, grade and major, were the most significant factors that influenced behavior (P < 0.05). The KAP of female college students in western Yunnan with regards to breast cancer were low. CONCLUSIONThere is an urgent need to provide standardized publicity and educational strategies in China to improve the knowledge, attitude, and practice, of college students with regards to breast cancer.

Comparison of Magnetic Resonance Imaging and Mammography in the Evaluation of Carcinoma Breast- A Longitudinal Observational Study

Introduction: Breast cancer is the most common malignancy in females worldwide. Mammography is a useful tool to diagnose breast cancer. Magnetic Resonance Imaging (MRI) has similar sensitivity like mammography to diagnose breast cancer, however MRI is more sensitive in diagnosing breast cancer in young females and patients with family history of breast cancer. Aim: To compare the sensitivity and specificity of MRI and mammography in the diagnosis of breast cancer. Materials and Methods: This was a longitudinal observational study done in the General Surgery Department of the study institute, from April 2018 to January 2020. Total 228 patients participated in the study. All patients, suspected to have breast cancer clinically, underwent mammography and MRI. The diagnosis was later confirmed by histopathological examination. The sensitivity and specificity of both MRI and mammography were determined by comparing with the results of histopathological examination using student’s t-test. Results: All 228 patients were females. In the study, it was found out that the sensitivity of mammography and MRI was 95% and 95.83%, respectively, in detecting breast cancer. The specificity of mammography and MRI was 89.28% and 83.33%, respectively. However, the differences were statistically non significant. Conclusion: From the study, it was found out that the sensitivity and specificity of MRI and mammography is similar in detecting breast cancer.

The correlation between blood lipids and clinicopathological features of breast cancer in young females.

Breast cancer is becoming more common in young adults. The relationships between blood lipids and breast cancer have been widely studied in recent years. In our current study, we investigated the potential correlations between blood lipids and clinicopathological features of breast cancer in young females. Fifty-nine young adults (40 years or younger) with pathologically confirmed invasive breast cancer that were treated in our center from October 2015 to March 2020 were enrolled in this study. These patients were divided into the negative group (n=40, with normal blood lipids) and positive group (n=19, with abnormal blood lipids) according to the preoperative blood lipid profiles, and differences in the clinicopathological features were compared between these two groups. Compared with the negative group, the positive group had a significantly higher rate of lymph node positivity (P=0.034); compared with the positive group, the negative group had a significantly higher rate of HER2 positivity (P=0.029). However, these two groups showed no significant difference in tumor size, molecular type, clinical stage, histological grade, tumor thrombus, and Ki-67 index (P values were 0.071, 0.227, 0.593, 0.396, 0.198, and 0.593, respectively). Blood lipid level has a certain correlation with lymph node metastasis and HER2 expression in young breast cancer patients. Therefore, blood lipid levels has a certain reference value in the clinical treatment of breast cancer.

Epidemiology of Breast Cancer in Young Lebanese Women Under the age of 40 Years: Retrospective Study in Lebanon between the Years 2011 and 2017

Background: Breast cancer is the most common non-skin malignancy affecting females in the world. In Lebanon, breast cancer rates are gradually increasing and young females are being more frequently affected. Few studies are available concerning this particular population. Objectives: This study aims to estimate the epidemiology of breast cancer in the young Lebanese females below the age of 40 with identification of variable characteristics and risk factors of the disease and ultimately, comparing our findings to other Arab countries. Methods: Breast cancer cases diagnosed at ≤ 40 years of age between 2011 and 2017 were collected from patient’s files in the Lebanese Hospital Geitaoui and Mount Lebanon Hospital, including the variable risk factors and tumors characteristics. The statistical data analysis was performed using SPSS statistics software. Results: 862 females were diagnosed with breast cancer in the aforementioned hospitals and forty-four were ≤ 40 years. The prevalence of breast cancer in the young Lebanese females is found to be 5.1%. Majority of cases (81.8%) were initially detected by breast self-examination. 20.5% had a positive family history. Infiltrative ductal carcinoma is the predominant histological subtype and grade 2 the most common histological grade. Estrogen and progesterone receptors are positive in 26 subjects and HER2/Neu receptors positive in 17 subjects. Most of cases were in stage 2A. Only 2 patients had BRCA gene testing done. Conclusion: The early onset breast cancer is not only related to the presence of a positive family history; other factors should be actively investigated. Breast self-examination should be considered as a screening method of breast cancer in young females at high risk.

Breast Cancer in Young Women: Status Quo and Advanced Disease Management by a Predictive, Preventive, and Personalized Approach.

Why does healthcare of breast cancer (BC) patients, especially in a young population, matter and why are innovative strategies by predictive, preventive, and personalized medicine (PPPM) strongly recommended to replace current reactive medical approach in BC management? Permanent increase in annual numbers of new BC cases with particularly quick growth of premenopausal BC patients, an absence of clearly described risk factors for those patients, as well as established screening tools and programs represent important reasons to focus on BC in young women. Moreover, "young" BC cases are frequently "asymptomatic", difficult to diagnose, and to treat effectively on time. The objective of this article is to update the knowledge on BC in young females, its unique molecular signature, newest concepts in diagnostics and therapy, and to highlight the concepts of predictive, preventive, and personalized medicine with a well-acknowledged potential to advance the overall disease management.

Does neoadjuvant treatment in breast cancer significantly modulate the biological markers in the surgical specimen, review of literature and meta analysis

Introduction: With a rising incidence of breast cancer in young females, there is also an increase in the use of neoadjuvant treatment for those patients.The aim of the neoadjuvant chemotherapy (NAC) , in addition to downsizing tumor stage to allow breast conservative surgery, is to assess tumor responsiveness in vivo to treatment. In the era of personalized treatment approach, it is mandatory to assess the estrogen (ER), progesterone (PR) and epidermal growth factor (HER2) receptors in all patients with breast cancer prior to treatment decision. The expression of hormonal receptors is the main pillar in decision making on adjuvant hormonal treatment.The same is true for the HER2 score evaluation to add trastuzumab in further treatment plan.

Possible mechanisms of development of carcinoma of breast in patients with early-onset cataract

Background: A nation-wide population based retrospective cohort study from Taiwan in 2014 suggested a propensity of developing breast cancer in young females with early-onset cataract. One such patient presented to us who was a young non-obese female with a large lump in the right breast with skin nodules and bilateral painless progressive diminution of vision. Patient was diagnosed as locally advanced carcinoma of right breast with axillary metastasis (stage IIIB) and bilateral early-onset nuclear cataract. Mechanism of this possible association has never been described.Methods: A comprehensive online English literature search was done using various electronic search databases. Different search terms related to pathogenesis of carcinoma breast and cataract, and their possible association, were used. An advanced search was further conducted by combining all the search fields in abstracts, keywords, and titles.Results: We summarized the data from the searched articles and found that there are certain biochemical pathways and genetic associations that link cancer to cataract. We identified four specific links between carcinoma breast and cataract (in some cases even early-onset cataract). The four mechanisms which explained this possible association included metabolic syndrome, action of reactive oxygen species, genetic polymorphisms and environmental factors.Conclusions: The evidence linking early-onset cataract with cancer is relatively new so possible mechanisms of development of breast cancer in patients with early-onset cataract needs to be elucidated. These plausible connections can further help to take up large scale molecular, biochemical, epidemiological and clinical studies to investigate this association in terms of cause-effect relationship. The impact this association can have, on understanding cataract and cancer pathogenesis; and its potential in reducing cancer incidence in patients with EOC, can be profound.

Invasive Ductal Carcinoma: Correlation of Immunophenotypic Features with Age.

To evaluate the frequency of hormone receptors and Her2neu expression and their correlation with age in patients of carcinoma breast. Descriptive, cross-sectional study. Department of Histopathology, Dr. Ziauddin Hospital, Karachi, between the period 2006 - 2013. Estrogen receptors, progesterone receptors and Her2neu immunohistochemical staining was performed on all specimens of carcinoma breast of female patients. Allred scoring was followed using normal epithelium as internal control. Age was determined in years. Results were described as percentages. Three hundred and forty-six cases of infiltrating ductal carcinoma of breast between the age of 20 - 90 years (mean= 49 ±14 years) were studied. Seventy-nine (23%) cases were below the age of 40 years. ER +ve cases were 210 (61%), PR +ve were 190 (55%), and 78 (23%) were Her2neu +ve. Three were 12 (3%) triple positive cases and 58 (17%) triple negative cases. One hundred and seven (31%) cases were ER/PR+ve and Her2neu -ve. Most of the breast cancer cases were aged between 41 - 50 years. Estrogen receptor positivity was maximum between 41 - 60 years. Fifty percent cases of carcinoma breast below 30-year age were also ER positive. A high proportion of breast cancer in young Pakistani females is alarming. Younger age harbours aggressive clinicopathologic characteristics. There is a due need for identifying high risk individuals/families including BRCA1 and BRCA2 testings, biologically driven trials devoted specifically to this group.

P173 Breast cancer in young females: recognition of age as a prognostic factor

P173 Breast cancer in young females: recognition of age as a prognostic factor

Age at diagnosis of female breast cancer in Oman: Issues and implications.

Introduction:Female breast cancer (BC) is the most frequent malignancy diagnosed globally, about 23% of the diagnosed cancers. BC incidence varies geographically, highest in Western Europe and lowest in Africa. BC in females is strongly correlated to age, the highest incidence rate amongst older women reinforcing the importance of hormonal status. BC in young females has an aggressive phenotype. There is a shared observation amongst practicing oncologists that BC in Middle East and the developing world presents at an earlier age.Aim and Objective:The aims of this study are to evaluate the age at presentation of female BC in Oman, and to compare our data with international and regional published data. It discusses the impact of young age Breast Cancer.Materials and Methods:All diagnosed female BC cases registered from 1996-2010 all over the country, were retrieved from the National Cancer Registry, Ministry of Health. BC cases were analyzed with respect to age at presentation. The data were compared with regional and international data.Results:A total of 14,109 cancer cases were recorded during the period of study. BC was the leading malignancy as 1,294 cases (9.1%). Female BC patients were 1,230; denoting 19.2% of all female cancers. 53.5% of female BC presented below 50 years of age. Male BC constituted 5% of total, with 67% of male BC occurring over 50 years of age. Compared with data from Oman, the highest rates in UK and other Western countries are above 50 years of age. These rates are four to 10 times higher than local in different age groups. Interestingly, these rates increase with increasing age in UK from 40-45 to up to 85+, keep on increasing and go up to four times higher with higher age. This phenomenon, of increasing incidence rates with age, is not observed in our local population.Discussion:BC is significantly correlated to age as reported from Western population. BC is reported at a younger age from developing and Arab World, which need to be further studied and validated. This phenomenon of BC in younger age may have significant implications and effects ranging from screening, diagnosis, management, prognosis, and cost of treatment.Conclusion:The impact on young women diagnosed with BC is enormous, ranging from psychosocial to healthcare services and economics. There is a need to study it further in depth in developing World.

Circulatory Estrogen Level Protects Against Breast Cancer in Obese Women

Literary data suggest apparently ambiguous interaction between menopausal status and obesity-associated breast cancer risk based on the principle of the carcinogenic capacity of estrogen. Before menopause, breast cancer incidence is relatively low and adiposity is erroneously regarded as a protective factor against this tumor conferred by the obesity associated defective estrogen-synthesis. By contrast, in postmenopausal cases, obesity presents a strong risk factor for breast cancer being mistakenly attributed to the presumed excessive estrogen-production of their adipose-tissue mass. Obesity is associated with dysmetabolism and endangers the healthy equilibrium of sexual hormone-production and regular menstrual cycles in women, which are the prerequisites not only for reproductive capacity but also for somatic health. At the same time, literary data support that anovulatory infertility is a very strong risk for breast cancer in young women either with or without obesity. In the majority of premenopausal women, obesity associated insulin resistance is moderate and may be counteracted by their preserved circulatory estrogen level. Consequently, it is not obesity but rather the still sufficient estrogen-level, which may be protective against breast cancer in young adult females. In obese older women, never using hormone replacement therapy (HRT) the breast cancer risk is high, which is associated with their continuous estrogen loss and increasing insulin-resistance. By contrast, obese postmenopausal women using HRT, have a decreased risk for breast cancer as the protective effect of estrogen-substitution may counteract to their obesity associated systemic alterations. The revealed inverse correlation between circulatory estrogen-level and breast cancer risk in obese women should advance our understanding of breast cancer etiology and promotes primary prevention measures. New patents recommend various methods for the prevention and treatment of obesity-related systemic disorders and the associated breast cancer.

Clinicopathological features of young patients (&lt;35 years of age) with breast cancer in a Japanese Breast Cancer Society supported study

To clarify the clinicopathological features of breast cancer in young females, surveillance data of the Registration Committee of the Japanese Breast Cancer Society were analyzed. The clinicopathological characteristics were compared between young (<35) patients and non-young (≥35) patients among 109,617 records registered between 2004 and 2009. The numbers of young and non-young patients were 2,982 (2.7 %) and 106,295 (97.0 %), respectively. The young patients had more cases of a familial history of breast cancer, more subjective symptoms, fewer bilateral tumors, lower BMIs, larger tumors, more positive lymph nodes, fewer instances of an ER-positive status, more instances of an HER2-positive status, more triple-negative tumors and more advanced TNM stages. The young patients more frequently received neoadjuvant chemotherapy and breast-conserving therapy (BCT) compared with the non-young patients. Eighty percent of all patients received adjuvant therapy. The young patients were more frequently treated with chemotherapy, molecular targeted therapy and radiation therapy than the non-young patients. In this study, young patients with breast cancer were diagnosed at more advanced stages and had more endocrine-unresponsive tumors than non-young patients. Further prognostic analyses should be conducted in this cohort.

Circulatory Estrogen Level Protects Against Breast Cancer in Obese Women

Literary data suggest apparently ambiguous interaction between menopausal status and obesity-associated breast cancer risk based on the principle of the carcinogenic capacity of estrogen. Before menopause, breast cancer incidence is relatively low and adiposity is erroneously regarded as a protective factor against this tumor conferred by the obesity associated defective estrogen-synthesis. By contrast, in postmenopausal cases, obesity presents a strong risk factor for breast cancer being mistakenly attributed to the presumed excessive estrogen-production of their adipose-tissue mass. Obesity is associated with dysmetabolism and endangers the healthy equilibrium of sexual hormone-production and regular menstrual cycles in women, which are the prerequisites not only for reproductive capacity but also for somatic health. At the same time, literary data support that anovulatory infertility is a very strong risk for breast cancer in young women either with or without obesity. In the majority of premenopausal women, obesity associated insulin resistance is moderate and may be counteracted by their preserved circulatory estrogen level. Consequently, it is not obesity but rather the still sufficient estrogen-level, which may be protective against breast cancer in young adult females. In obese older women, never using hormone replacement therapy (HRT) the breast cancer risk is high, which is associated with their continuous estrogen loss and increasing insulin-resistance. By contrast, obese postmenopausal women using HRT, have a decreased risk for breast cancer as the protective effect of estrogen-substitution may counteract to their obesity associated systemic alterations. The revealed inverse correlation between circulatory estrogen-level and breast cancer risk in obese women should advance our understanding of breast cancer etiology and promotes primary prevention measures. New patents recommend various methods for the prevention and treatment of obesity-related systemic disorders and the associated breast cancer.

Molecular Subtypes of Breast Cancer Emerging in Young Women in Taiwan: Evidence for More Than Just Westernization as a Reason for the Disease in Asia

In the past two decades, the incidence of breast cancer in young Taiwanese females has been rapidly increasing, approaching the risk level of western countries. As a first step to investigate the possible etiology, we examined the molecular subtypes of female breast cancer in Taiwan. This study included 1,028 consecutive patients with breast cancer diagnosed in National Taiwan University Hospital between 2004 and 2006. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2, cytokeratin 5/6, and epidermal growth factor receptor expression and/or gene amplification were analyzed. Younger (<or=50 years) breast cancer patients had a higher prevalence of luminal A (67% versus 57%; P < 0.001) and a lower prevalence of basal-like subtype (9% versus 17%; P < 0.001) compared with older (>50 years) patients. The higher prevalence of luminal A subtype was mainly attributed to a higher ER (75% versus 63%; P < 0.001) and PR (47% versus 33%; P < 0.001) expression rate in younger patients than older patients. Tumors with histologic grade 3 were less prevalent in younger patients than in older patients (23% versus 30%; P = 0.01). For very young (<35 years) patients, the molecular subtype distribution, ER and/or PR expression rate, and histologic grade were not significantly different from those of less young (35-50 years) patients. Young breast cancer patients in Taiwan are characterized by a high prevalence of luminal A subtype and low prevalence of histologic grade 3 tumor and/or basal-like subtype. These features are distinct from young breast cancer patients in western countries.