Young patients with breast cancer (< 35 years): Single-institution study of 194 patients from India.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11013-e11013
Author(s):  
B. K Mohanti ◽  
Vinod Raina ◽  
Ajay Gogia ◽  
S. V. S Deo ◽  
N. K Shukla
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Positive Family History ◽  
Young Patients ◽  
Radical Mastectomy ◽  
Histopathological Analysis ◽  
Duration Of Symptoms ◽  
Young Breast Cancer

e11013 Background: Breast cancer in young women ( < 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West .There is paucity of data on young breast cancer from India. The aim of our study was to assess clinical and pathological parameters and outcome in young breast cancer patients. Methods: Annually we register approximately 350 new cases of breast cancer of whom young patients constitute a small fraction. This analysis was carried out in 194 patients with aged 35 years or less, who were registered in our clinic between 2000-2009, this constituted about 5.5 % of all new cases. Patients records were analysed from computer database using ICD code (C-50) Results: The median age was 31 years (range 21-35). The median duration of symptoms was 11.8 months (range 0.5-40). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in 8 patients, and 3 patients presented with synchronous malignancy. The TNM (7th edition) stage distribution was stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.9 cm. Modified Radical mastectomy was the commonest surgical procedure and this was done in 81 % of cases. The histopathological analysis showed 94% had infiltrating ductal carcinoma. Sixty percent of tumours were high grade and 56% had pathological node positive disease. ER/PR status and Her2 Neu status was available in 65% and 50% respectively. Out of these patients ER and her2neu positivity was 40% and 37% respectively. Triple negative breast cancer (TNBC) constituted 31%. A combination of anthracyclines and taxanes were used in the vast majority of patients and herceptin was used only in 5 %. With a median follow up of 30 months, three years event free (EFS) and overall survival (OS) was 50% and 60%. Higher Nodal stage, tumour size (>5 c.m ), negative ER/PR status and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 5.5% cases with higher proportion of triple negativity, this is higher than the western population reflecting younger age of our population of breast cancer in general with a resultant poorer outcome.

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

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22196-e22196
Author(s):  
R. Rejiv ◽  
D. Biswajit ◽  
R. Neelesh ◽  
V. Sridevi ◽  
T. G. Sagar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Ductal Carcinoma ◽  
Locally Advanced ◽  
Young Patients ◽  
Stage Iv ◽  
Radical Mastectomy ◽  
Reproductive Age ◽  
Breast Cancer Patients ◽  
Pregnancy And Lactation

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.

scholarly journals Clinical utility of genomic signatures in young breast cancer patients: a systematic review

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Cynthia Villarreal-Garza ◽  
Ana S. Ferrigno ◽  
Cynthia De la Garza-Ramos ◽  
Regina Barragan-Carrillo ◽  
Matteo Lambertini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Women ◽  
Young Patients ◽  
Distant Recurrence ◽  
Similar Rate ◽  
Breast Cancer Patients ◽  
Genomic Signatures ◽  
Hormone Sensitive ◽  
Young Breast Cancer

Abstract Risk stratification by genomic signatures has been shown to improve prognostication and guide treatment decisions among patients with hormone-sensitive breast cancer. However, their role in young women has not been fully elucidated. In this review, a systematic search was conducted for published articles and abstracts from major congresses that evaluated the use of genomic signatures in young breast cancer patients. A total of 71 studies were analyzed, including 561,188 patients of whom 27,748 (4.9%) were young. Women aged ≤40 years were subjected to genomic testing at a similar rate to older women but had a higher proportion of intermediate- to high-risk tumors when classified by EndoPredict (p = 0.04), MammaPrint (p < 0.01), and Oncotype DX (p < 0.01). In young women with low genomic risk, 6-year distant recurrence-free survival was 94%, while 5-year overall survival was nearly 100%. Nonetheless, young patients classified as low-risk had a higher tendency to receive chemotherapy compared to their older counterparts. In conclusion, genomic tests are useful tools for identifying young patients in whom chemotherapy omission is appropriate.

scholarly journals A rare case of isolated adrenal metastasis of invasive ductal breast carcinoma

2014 ◽  
Vol 142 (9-10) ◽  
pp. 597-601 ◽  
Author(s):  
Natasa Andjelic-Dekic ◽  
Ivana Bozovic-Spasojevic ◽  
Snezana Milosevic ◽  
Miodrag Matijasevic ◽  
Katarina Karadzic
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Computerized Tomography ◽  
Ductal Carcinoma ◽  
Radical Mastectomy ◽  
Histopathological Analysis ◽  
Adrenal Metastases ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
One Year

Introduction. Isolated adrenal metastases of invasive ductal breast carcinoma are extremely rare. We report a case with isolated left adrenal metastases, verified three years after diagnosed breast carcinoma. Case Outline. A 58-year-old female patient with a right breast tumor, clinically staged as IIIA (T2N2M0) started neoadjuvant anthracycline chemotherapy after biopsy which revealed invasive ductal breast carcinoma. Immunohistochemical findings of tumor biopsy showed hormonal steroid receptors for estrogen and progesterone negative, and human epidermal growth factor receptor 2 (HER2) positive. After 4 cycles of chemotherapy and partial tumor regression the patient underwent radical mastectomy. Definite histopathological analysis confirmed the diagnosis of invasive ductal carcinoma. The patient continued treatment with adjuvant chemotherapy to cumulative dose of anthracyclines, postoperative radiotherapy and adjuvant trastuzumab for one year. Three years later abdominal computerized tomography showed tumor in the left adrenal gland as the only metastatic site. Left adrenalectomy was performed and histopathological finding confirmed breast cancer metastases. Postoperatively, the patient received 6 cycles of docetaxel with trastuzumab and continued trastuzumab until disease progression. One year after left adrenalectomy control abdominal computerized tomography showed a right adrenal tumor with retroperitoneal lymphadenopathy. Treatment with capecitabine was continued for one year, but eventually she developed brain metastasis causing lethal outcome. Conclusion. In order to better understand metastatic pathways of invasive ductal breast carcinoma, publications of individual patient cases diagnosed with rare metastatic sites should be encouraged. This might improve our understanding of metastatic behavior of breast cancer and stimulate further clinical research.

The importance of fertility preservation in women with early breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20663-e20663
Author(s):  
A. Agbarya ◽  
S. Linn
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Large Scale ◽  
Breast Cancer Survivors ◽  
Early Stage ◽  
Young Patients ◽  
Future Research ◽  
Medical Procedure ◽  
Young Breast Cancer

e20663 Background: Young women with breast cancer often seek advice regarding treatment effects on their fertility. The purpose of this study was to gain a better understanding of women's attitudes to fertility and how these concerns affect decision-making. Methods: A survey on fertility issues was developed for young women with a history of early-stage breast cancer. The survey was completed by direct interviews with the patients. Results: Eighty-four eligible respondents completed the survey. Mean age at breast cancer diagnosis was 34.7 years. Fifty-seven percent of the women were Jewish and 43% were Arabic; 71% were married; 75% had more than 12 years of education. Stages at diagnosis were: I - 51%; II - 38%; III - 11%. Seventy-seven percent of the women were within six months of diagnosis and 49% reported substantial concern about becoming infertile with treatment. In multivariate logistic regression, a greater concern about infertility was associated with a wish for children (p=0.0008), number of children less than three (p=0.001), more than 12 years of education (p=0.004), and a moderate or high level of fear of treatment (p=0.004). Seventy-nine percent of patients reported discussing fertility concerns with their doctors, and 14% underwent a medical procedure for fertility preservation. Only five patients stated that infertility concerns influenced their treatment decisions. Conclusions: 1. Fertility after treatment is a major concern for young breast cancer patients undergoing chemotherapy. 2. This statement was not affected by ethnicity. 3. There is a need to communicate with and educate young patients regarding fertility issues and large scale future research directed at preserving fertility for young breast cancer survivors is warranted. No significant financial relationships to disclose.

Breast cancer in the young (≤35 years): A single center study from the All India Institute of Medical Sciences.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12539-e12539
Author(s):  
Vinod Raina ◽  
Ajay Gogia ◽  
B. K. Mohanti ◽  
S. V. S. Deo ◽  
N. K. Shukla ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Women ◽  
Triple Negative ◽  
Tumour Size ◽  
Breast Cancer Patients ◽  
Visceral Metastasis ◽  
Nodal Stage ◽  
Her 2 ◽  
Young Breast Cancer

e12539 Background: Breast cancer in young women (</= 35 years) is uncommon and accounts for 1-2 % of all breast cancer in the West. There is limited data on breast cancer in the young from India. The aim of our study was to assess clinical, pathological parameters and outcome in young breast cancer patients. Methods: We carried out an analysis of 271 patients of young breast cancer patients (</=35 years) registered between 2000 to 2012 at I.R.C.H, AIIMS, New Delhi, India. Results: The median age was 31 years (range 18-35). The median duration of symptoms was 10 months (range 0.25-60). Breast lump was the commonest (93%) presenting symptom (left >right side). Ninety percent of patients were married and median age at first child birth was 23 years. Positive family history was elicited in only 15 patients. The TNM stage distribution was: stage I was 3 %, stage II- 20%, stage III- 55%, and stage IV- 22%. The median clinical tumour size was 5.1 cm. Modified radical mastectomy was the commonest surgical procedure and this was done in 80 % of cases. The histopathological analysis showed 93% had infiltrating ductal carcinoma. Thirty percent of tumours were high grade and 55% had pathological node positive disease. ER/PR and her-2neu positivity was 33% and 30% respectively. Triple negative breast cancer (TNBC) constituted 33%. Fifty five patients presented with metastasis. A combination of anthracycline and taxanes were used in the majority of patients and Trastuzumab could be used only in 6 cases out of 72 patients who were Her-2 neu positive. With a median follow up of 30 months (non metastatic group), three years disease free survival (DFS) and overall survival (OS) was 50% and 60%. Higher nodal stage, tumour size (>5 cm), negative hormonal status (triple negative) and visceral metastasis at baseline predicted poor outcome. Conclusions: Young women constituted 8 % of breast cancer cases, this proportion is much higher than the published Western figures of 1-2 % and reflects younger age of our population. Even in this young group ER/ PR positivity was 33% and almost a third were her-2 neu positive. Higher nodal stage, tumour size (>5 cm), triple negativity and visceral metastasis at baseline predicted poor outcome.

Study of breast cancer surgeries at a tertiary hospital

2021 ◽  
Vol 18 (3) ◽  
pp. 93-97
Author(s):  
Pandit Shamarao Powar ◽  
Keyword(s):  
Breast Cancer ◽  
Rural Areas ◽  
Ductal Carcinoma ◽  
Hormone Replacement ◽  
Positive Family History ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Tertiary Hospital ◽  
Breast Conservation Surgery ◽  
Modified Radical Mastectomy

Background: Breast cancer is commonly treated by various combinations of surgery, chemotherapy, radiation therapy, hormone therapy and targeted therapy via a multimodality approach. Surgery is the mainstay of treatment of the early stages of breast cancer, and it ranges from lumpectomy to modified radical mastectomy. Surgery typically includes sentinel lymph nodes (LN) dissection for staging the extent of spread into the axilla. In present study we aimed to study surgeries done in patients with breast cancer at our tertiary hospital. Material and Methods: Present study was a prospective, observational study conducted in patients who underwent surgery for breast cancer, followed by histopathological report positive for breast malignancy. Results: Total 86 biopsy proven breast cancer patients underwent surgery during study period. All patients were females, with mean age 47.4 ± 10.7 years, from rural areas (74%), 9% had positive family history, 13% received Hormone Replacement Therapy/Oral Contraceptive Pills (for more than 5 years), 5% were smokers, 64% were premenopausal and 7% had history of breast biopsy. Modified radical mastectomy with axillary node dissection (69%) was most common surgery performed followed by breast conservation surgery (26%). Most patients were from stage II (64%) followed by stage I (15%). Infiltrating ductal carcinoma was most common histopathological variant (81%). Histopathologically most cancers were grade II (52%). Lymph nodal involvement (48%) and positive surgical margins (7%) were noted. Conclusion: Surgery is mainstay in treatment of breast cancer With introduction of BCS cosmetic and other concerns are tackled effectively.

scholarly journals Determining the Unique Radiological Features of Lobular Breast Cancer on Imaging in Histopathologically Proven Cases – Our Institutional Experience

2021 ◽  
Vol 10 (18) ◽  
pp. 1296-1301
Author(s):  
Kashifa Rahamath ◽  
Bhawna Dev ◽  
Venkata Sai P.M
Keyword(s):  
Breast Cancer ◽  
Invasive Ductal Carcinoma ◽  
Invasive Lobular Carcinoma ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Lobular Carcinoma ◽  
Positive Family History ◽  
Architectural Distortion ◽  
Breast Carcinomas ◽  
Diagnostic Challenge

BACKGROUND Lobular breast carcinomas have always been a diagnostic challenge, over the years, to the radiologist. They are one of the most commonly missed lesions on breast cancer screening checks, due to their varied presentation. We wanted to provide a concise and practical approach to characterise their morphology and presentation on mammography and ultrasound. METHODS A retrospective study was done for four years and a total of 699 patients with histopathologically proven breast cancer were chosen. Those patients with invasive lobular carcinoma (N = 56) and invasive ductal carcinoma (N = 538) were segregated and 50 cases from each group were selected randomly. RESULTS On mammography, an irregular, high-density mass was the most common presentation of both lobular (68 %) and ductal (86 %) carcinomas. Presentation as focal asymmetry (28 %) was significantly more prevalent in lobular breast carcinomas. Sonographically, an architectural distortion (30 %) and non-parallel orientation (28 %) was predominantly seen in invasive lobular carcinomas (ILCs). Mass (88 %) with micro lobulated (34 %) or angular (22 %) margins was more in favour of ductal carcinoma. Other general parameters like age at presentation, positive family history, multifocality, bilaterality, tumour size and lymph nodal involvement were not significantly different between both the groups. CONCLUSIONS A careful analysis of digital breast tomosynthesis and ultrasonography, keeping in mind all the clear differentiating features, along with experience in the field, will dramatically increase the early detection of lobular breast cancers. KEY WORDS Invasive Lobular Carcinoma (ILC), Invasive Ductal Carcinoma (IDC), X-Ray Mammography, Sono-Mammography

Web-Based Survey of Fertility Issues in Young Women With Breast Cancer

2004 ◽  
Vol 22 (20) ◽  
pp. 4174-4183 ◽  
Author(s):  
Ann H. Partridge ◽  
Shari Gelber ◽  
Jeffrey Peppercorn ◽  
Ebonie Sampson ◽  
Katherine Knudsen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Cancer Survivors ◽  
College Graduates ◽  
Early Stage ◽  
Young Patients ◽  
Breast Cancer Diagnosis ◽  
Future Research ◽  
History Of ◽  
Young Breast Cancer

Purpose Young women with breast cancer often seek advice about whether treatment will affect their fertility. We sought to gain a better understanding of women’s attitudes about fertility and how these concerns affect decision making. Patients and Methods We developed a survey about fertility issues for young women with a history of early-stage breast cancer. The survey was e-mailed to all registered Young Survival Coalition survivor members (N = 1,702). E-mail reminders were used. Results Six hundred fifty-seven eligible respondents completed the survey. Mean age at breast cancer diagnosis was 32.9 years; mean current age was 35.8 years. Ninety percent of women were white; 62% were married; 76% were college graduates. Stages at diagnosis were as follows: 0, 10%; I, 27%; II, 47%; III, 13%. Sixty-two percent of women were within 2 years of diagnosis. Fifty-seven percent recalled substantial concern at diagnosis about becoming infertile with treatment. In multivariate logistic regression, greater concern about infertility was associated with wish for children/more children (odds ratio [OR], 120; P < .0001), number of prior pregnancies (OR, 0.78; P = .01), and prior difficulty conceiving (OR, 1.86; P = .08). Twenty-nine percent of women reported that infertility concerns influenced treatment decisions. Seventy-two percent of women reported discussing fertility concerns with their doctors; 51% felt their concerns were addressed adequately. Women seemed to overestimate their risk of becoming postmenopausal with treatment. Conclusion Fertility after treatment is a major concern for young women with breast cancer. There is a need to communicate with and educate young patients regarding fertility issues at diagnosis and a need for future research directed at preserving fertility for young breast cancer survivors.

scholarly journals The Biological and Clinical Significance of Glutaminase in Luminal Breast Cancer

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3963
Author(s):  
Brendah K. Masisi ◽  
Rokaya El Ansari ◽  
Lutfi Alfarsi ◽  
Madeleine L. Craze ◽  
Natasha Jewa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Outcome ◽  
Ductal Carcinoma ◽  
Tumour Size ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Glutamine Metabolism ◽  
Gene Copy ◽  
Luminal Breast Cancer ◽  
Potential Biomarker

The glutamine metabolism has a key role in the regulation of uncontrolled tumour growth. This study aimed to evaluate the expression and prognostic significance of glutaminase in luminal breast cancer (BC). The glutaminase isoforms (GLS/GLS2) were assessed at genomic/transcriptomic levels, using METABRIC (n = 1398) and GeneMiner datasets (n = 4712), and protein using immunohistochemistry in well-characterised cohorts of Oestrogen receptor-positive/HER2-negative BC patients: ductal carcinoma in situ (DCIS; n = 206) and invasive breast cancer (IBC; n = 717). Glutaminase expression was associated with clinicopathological features, patient outcome and glutamine-metabolism-related genes. In DCIS, GLS alone and GLS+/GLS2- expression were risk factors for shorter local recurrence-free interval (p < 0.0001 and p = 0.001, respectively) and remained prognostic factors independent of tumour size, grade and comedo necrosis (p = 0.0008 and p = 0.003, respectively). In IBC, GLS gene copy number gain with high mRNA expression was associated with poor patient outcome (p = 0.011), whereas high GLS2 protein was predictive of a longer disease-free survival (p = 0.006). Glutaminase plays a role in the biological function of luminal BC, particularly GLS in the early non-invasive stage, which could be used as a potential biomarker to predict disease progression and a target for inhibition. Further validation is required to confirm these observations, and functional assessments are needed to explore their specific roles.

scholarly journals Real-World Data Related to Non-Metastatic Breast Cancer in Young Women: Experience of a Single Institution

2018 ◽  
Vol 64 (1) ◽  
pp. 45-53
Author(s):  
Juliana Cunha e Silva Ominelli De Souza ◽  
Andrew Sá Nunes ◽  
Jesse Lopes Da Silva ◽  
Aline Coelho Gonçalves ◽  
Suzanne Crocamo Ventilari Da Costa
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Young Women ◽  
Advanced Disease ◽  
Young Patients ◽  
Metastatic Breast ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Node Involvement

Introduction: Breast cancer is the leading cause of cancer-related deaths in women aged 20-59 years. Younger women usually have more aggressive tumors and more advanced disease with larger size and axillary lymph node involvement. There have been few studies assessing the characteristics of breast cancer in very young women. Objective: Evaluate the epidemiological and clinical profile of non-metastatic very young patients with breast cancer. Method: We performed a retrospective analysis to evaluate the epidemiological and clinical profile of non-metastatic breast cancer in patients ≤ 30 years of age treated between 1993 and 2011 at the Brazilian National Cancer Institute José Alencar Gomes da Silva. We evaluated relapse-free survival (RFS) and overall survival (OS). Results: Of the 196 patients evaluated, 181 (90%) had ductal carcinoma, 79 (40%) had high-grade tumors, and 102 (52%) had hormone receptor-positive tumors. 117 patients(60%) had stage III disease at diagnosis. The median age was 29 years (range, 17-30 years). Of 185 patients who underwent surgery, 156 (84.3%) underwent total mastectomy and 171 (92%) underwent axillary lymph node dissection. 119 patients received neoadjuvant chemotherapy, and 14 patients (9.3%) underwent neoadjuvant radiotherapy. After a median follow-up of 81.5 months, 109 patients (55%) had relapsed and 81 (41%) had died. The median RFS and OS were 49.5 months and 134 months, respectively. Lymph node involvement and neoadjuvant chemotherapy were associated with shorter RFS and OS. Conclusion: Breast cancer is uncommon in young patients, especially in those ≤ 30 years of age. We found a predominance of locally advanced disease and worse prognostic pathological characteristics. Despite the aggressive treatment, our patients had worse outcomes than those reported by other authors.

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