Breast Cancer in Young Females: Real-World Data to Fill the Gap - European Medical Journal
×

Browse

Breast Cancer in Young Females: Real-World Data to Fill the Gap

| Oncology
EMJ Oncology 8.1 2020 Feature Image
Authors:
*Mariola Blanco Clemente, Beatriz Núñez García, Juan Cristóbal Sánchez González, Miriam Méndez García, Ramón Aguado Noya, Ana María Morito Aguilar, Guillermo Visedo Ceballos, Constanza Maximiano Alonso, Mariano Provencio Pulla, Blanca Cantos Sánchez de Ibargüen
Disclosure:

The authors have declared no conflicts of interest.

Citation
EMJ Oncol. ;8[1]:43-45. Abstract Review No. AR1.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

BACKGROUND

Breast cancer (BC) is the most common cause of cancer-related deaths in females under 45 years. It has been reported as a more aggressive disease, requires more aggressive treatment, has a poorer survival rate, and leads to more serious psychosocial consequences. Evidence about the epidemiology, biologic behaviours, and treatment strategies are needed to help clinicians understand this disease. The young female population is under-represented in clinical studies and therefore, real-world data could be useful in broadening knowledge and aiding management of patients.

METHODS

The authors conducted a retrospective study, selecting patients aged ≤45 years with BC diagnosis in the Breast Cancer Unit of Puerta de Hierro Hospital, Majadahonda, Spain between 2014 and 2019. Epidemiological, clinical, and pathological information was collected. The aim was to understand the characteristics of the breast cancer in young females (BCYF) patient population and to assess the quality of care of the diagnostics and treatments.

RESULTS

A total of 348 patients with diagnosis of BC were selected; median age was 41 years (range: 38–44 years) with the majority (61%) aged 41–44 years.

Clinical and epidemiological characteristics of the patient cohort are described below: 79.9% of the patients had a previous pregnancy and almost half (49.0%) breastfed. Of the patients studied, 52% had never smoked, with this percentage being higher in the <35 years subgroup (68.8%). Regarding oral contraceptive intake, 44.3% of patients had used them at some point in their life, which increased to 54.6% in the <35 years subgroup. Median BMI was 22.8. In relation to family history, 32.0% had a history of breast cancer and 4.6% had a history of ovarian cancer. A BRCA 1/2 mutation was carried by 7.4% of the patients; this percentage reached 21.1% in the <35 years subgroup.

Analysis of the histological characteristics revealed results as follows: the most common histological type was ductal (84.5%) followed by lobular (8.3%), with no significant differences between age subgroups. The hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) subtype was the most prevalent (69.5%), followed by HR+/HER2+ (14.3%); 11.2% were triple-negative and only 5% were HER2+/HR-. Most of the patients presented at Stage I or II (38.1% and 38.4%, respectively); 18.6% presented at Stage III and 4.9% were metastatic at diagnosis (data consistent with literature). In relation to axillary staging, 43.8% were positive at diagnosis and this was similar between the three subgroups.

CONCLUSIONS

In our BCYF cohort, no association was found between age groups and clinical or pathological characteristics, which differs from other previously published studies reporting a poorer prognosis in young females.

The cohort distribution, per stages and subtypes, was similar to the global population described in the medical literature. This suggests the need for a detailed BCYF analysis to find evidence for the specific management of this population, and to prevent age-related disparities in BC care.

Table 1: Clinical and pathological characteristics of breast cancer in the young females’ cohort.
FA: fibroadenoma; HER2: human epidermal growth factor receptor 2; HR: hormone receptor; TN: triple negative.

References
Plichta JK et al. Breast cancer tumor histopathology, stage at presentation, and treatment in the extremes of age. Breast Cancer Res Treat. 2020;180(1):227-35. Paluch-Shimon S et al. ESO-ESMO 4th international consensus guidelines for breast cancer in young women (BCY4). Ann Oncol. 2020;S0923-7534(20):36363-8. Fabiano V et al. Breast cancer in young women presents with more aggressive pathologic characteristics: retrospective analysis from an Argentine national database. JCO Glob Oncol. 2020;6:639-46. Mealey NE et al. Mutational landscape differences between young-onset and older-onset breast cancer patients. BMC Cancer. 2020;20(1):212. Thomas A et al. Incidence and survival among young women with Stage I-III breast cancer: SEER 2000-2015. JNCI Cancer Spectr. 2019;3(3):pkz040. Howlader N et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;106(5):dju055.