J Breast Cancer.  2009 Jun;12(2):79-84. 10.4048/jbc.2009.12.2.79.

Imaging and Clinicopathologic Characteristics of Breast Cancers in Younger Group Compared to in Old Group

• Choi YJ
• Kook SH
• Kwag HJ
• Park YL

• KMID: 2175200
• DOI: http://doi.org/10.4048/jbc.2009.12.2.79

Abstract

PURPOSE: We wanted to evaluate the difference of the images and the clinicopathological characteristics of young-age female breast cancer patients as compared to older Korean women with breast cancer.
METHODS
A total of 351 breast cancers cases during the previous 3 years were evaluated. A cut-off level of 40 years was used to divide the patients into the young (< or =40 years, 86 cases, 24.5%) and older groups (>40 years, 265 cases, 75.5%). We reviewed the BI-RADS results, the sensitivity of mammography (MMG) and sonography (US), the presenting symptoms, the histopathological type, the post-operative stage and the receptor status. These factors were compared between the young age group and the older age group. Chi-squared tests were used for statistical analysis.
RESULTS
BI-RADS category 1 disease on the MMG (12.8% vs 6.4%, respectively) and BI-RADS category 3 disease on the US (3.5% vs 1.1%) were more common for the younger group as compared to the older group. The sensitivity of MMG and US was lower for the younger group than for the older group (69.2% and 82.3% vs 84.5% and 93.3%, respectively). Clinical symptom, histopathology, final stage, and the size of tumor or receptor status did not show statistical significant differences.
CONCLUSION
Imaging young women breast cancers were less sensitive, more frequently assessed as normal on MMG and as more probably benign on US, and no clinicopathological differences were shown.

Keyword

Breast neoplasms; Mammography; Ultrasound; Young age

MeSH Terms

Breast
Breast Neoplasms
Female
Humans
Mammography

Reference

1. Hankey BF, Miller B, Curtis R, Kosary C. Trends in breast cancer in younger women in contrast to older women. J Natl Cancer Inst Monogr. 1994. (16):7–14.

2. Ahn SH, Hwang UK, Kwak BS, Yoon HS, Ku BK, Kang HJ, et al. Prevalence of BRCA1 and BRCA2 mutations in Korean breast cancer patients. J Korean Med Sci. 2004. 19:269–274.

3. Yoo KY, Kang D. Current researches on breast cancer epidemiology in Korea. Breast Cancer. 2003. 10:289–293.

4. Brand IR, Sapherson DA, Brown TS. Breast imaging in women under 35 with symptomatic breast disease. Br J Radiol. 1993. 66:394–397.

5. Houssami N, Irwig L, Loy C. Accuracy of combined breast imaging in young women. Breast. 2002. 11:36–40.

6. Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: clinicopathological features and biological specificity. Breast. 2003. 12:247–250.

7. Chung M, Chang HR, Bland KI, Wanebo HJ. Younger women with breast carcinoma have a poorer prognosis than older women. Cancer. 1996. 77:97–103.

8. Han W, Kim SW, Park IA, Kang D, Kim SW, Youn YK, et al. Young age: an independent risk factor for disease-free survival in women with operable breast cancer. BMC Cancer. 2004. 4:82.

9. Di Nubila B, Cassano E, Urban LA, Fedele P, Abbate F, Maisonneuve P, et al. Radiological features and pathological-biological correlations in 348 women with breast cancer under 35 years old. Breast. 2006. 15:744–753.

10. Foo CS, Su D, Chong CK, Chng HC, Tay KH, Low SC, et al. Breast cancer in young Asian women: study on survival. ANZ J Surg. 2005. 75:566–572.

11. Hartley MC, McKinley BP, Rogers EA, Kalbaugh CA, Messich HS, Blackhurst DW, et al. Differential expression of prognostic factors and effect on survival in young (< or =40) breast cancer patients: a case-control study. Am Surg. 2006. 72:1189–1194.

12. Hindle WH, Davis L, Wright D. Clinical value of mammography for symptomatic women 35 years of age and younger. Am J Obstet Gynecol. 1999. 180:1484–1490.

13. Johnstone PA, Moore EM, Carrillo R, Goepfert CJ. Yield of mammography in selected patients age or < =30 years. Cancer. 2001. 91:1075–1078.

14. D'Orsi CJ. American College of Radiology. Illustrated breast imaging reporting and data system (illustrated BI-RADS). 1998. 3rd ed. Reston: American College of Radiology.

15. Yoo KY, Kang D, Park SK, Kim SU, Kim SU, Shin A, et al. Epidemiology of breast cancer in Korea: occurrence, high-risk groups, and prevention. J Korean Med Sci. 2002. 17:1–6.

16. Lee SY, Jeong SH, Kim J, Jung SH, Song KB, Nam CM. Scheduling mammography screening for the early detection of breast cancer in Korean women. J Med Screen. 2007. 14:205–209.

17. Liberman L, Dershaw DD, Deutch BM, Thaler HT, Lippin BS. Screening mammography: value in women 35-39 years old. AJR Am J Roentgenol. 1993. 161:53–56.

18. Bassett LW, Ysrael M, Gold RH, Ysrael C. Usefulness of mammography and sonography in women less than 35 years of age. Radiology. 1991. 180:831–835.

19. Cohen MI, Mintzer RA, Matthies HJ, Bernstein JR. Mammography in women less than 40 years of age. Surg Gynecol Obstet. 1985. 160:220–222.

20. Grumbach Y, Nguyen HT. Mammography in younger women. Curr Opin Radiol. 1991. 3:602–610.

21. Muttarak M, Pojchamarnwiputh S, Chaiwun B. Breast cancer in women under 40 years: preoperative detection by mammography. Ann Acad Med Singapore. 2003. 32:433–437.

22. Shaw de Paredes E, Marsteller LP, Eden BV. Breast cancers in women 35 years of age and younger: mammographic findings. Radiology. 1990. 177:117–119.

23. Houssami N, Irwig L, Simpson JM, McKessar M, Blome S, Noakes J. Sydney Breast Imaging Accuracy Study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms. AJR Am J Roentgenol. 2003. 180:935–940.

24. Lee WY. Frequent loss of BRCA1 nuclear expression in young women with breast cancer: an immunohistochemical study from an area of low incidence but early onset. Appl Immunohistochem Mol Morphol. 2002. 10:310–315.

25. Golshan M, Miron A, Nixon AJ, Garber JE, Cash EP, Iglehart JD, et al. The prevalence of germline BRCA1 and BRCA2 mutations in young women with breast cancer undergoing breast-conservation therapy. Am J Surg. 2006. 192:58–62.

26. Ahn SH, Son BH, Kim SW, Kim SI, Jeong J, Ko SS, et al. Poor outcome of hormone receptor-positive breast cancer at very young age is due to tamoxifen resistance: nationwide survival data in Korea--a report from the Korean Breast Cancer Society. J Clin Oncol. 2007. 25:2360–2368.

27. Colleoni M, Rotmensz N, Robertson C, Orlando L, Viale G, Renne G, et al. Very young women (< 35 years) with operable breast cancer: features of disease at presentation. Ann Oncol. 2002. 13:273–279.