J Korean Soc Radiol.  2017 Jun;76(6):375-385. 10.3348/jksr.2017.76.6.375.

Clinicopathological and Imaging Features of Breast Cancer in Korean Women under 40 Years of Age

• Kim J
• Jang M
• Kim SM
• Yun BL
• Lee JY
• Kim EK
• Kang E
• Park SY

• KMID: 2379319
• DOI: http://doi.org/10.3348/jksr.2017.76.6.375

Abstract

PURPOSE
To evaluate the clinicopathological and imaging features of mammography, ultrasonography, and magnetic resonance imaging (MRI) for breast cancer in Korean women under 40 years of age according to molecular subtypes.
MATERIALS AND METHODS
We included 183 breast cancers in 176 consecutive women under 40 years old who had been diagnosed with breast cancer between January 2012 and November 2014. The patients' clinical and pathologic records were available as electronic medical records. A retrospective review of the pre-operative imaging studies was performed with 177 mammographies, 183 ultrasonographies, and 178 MRIs.
RESULTS
Eighty-six percent (158/183) of lesions were symptomatic, with masses (147/183) as the most common presentation. Eighty percent (22/25) of the asymptomatic lesions were diagnosed via screening ultrasonography. The luminal A subtype was the most common (n = 79, 43%), human epidermal growth factor receptor 2-enriched subtype showed indistinct margins on mammography (p = 0.006), the triple negative subtype depicted a posterior enhancement on ultrasonography (p < 0.001) and rim enhancement on MRI (p < 0.001).
CONCLUSION
Breast cancers in Korean women under 40 years of age are commonly presented with a palpable mass, and luminal A is the most common molecular subtype. In our study, the imaging and pathologic characteristics of breast cancer in younger women were similar to those previously reported for older patients.

MeSH Terms

Breast Neoplasms*
Breast*
Electronic Health Records
Female
Humans
Magnetic Resonance Imaging
Mammography
Mass Screening
Phenobarbital
Receptor, Epidermal Growth Factor
Retrospective Studies
Ultrasonography
Young Adult
Phenobarbital
Receptor, Epidermal Growth Factor

Figure

• 

  Fig. 1. Luminal A type breast cancer of 37-year-old woman. A. Right mediolateral oblique mammography shows 2 cm-sized isodense mass with irregular shape and indistinct margin (arrow) on the right lower breast. B. Ultrasonography shows 2.5 cm-sized hypoechoic mass with irregular shape and indistinct margin (arrows) in the right 6 o'clock direction. C. Axial contrast-enhanced T1-weighted MR image with fat suppression shows a 2.5 cm-sized heterogeneously enhancing mass with an irregular shape and margin (arrows).

• 

  Fig. 2. Triple negative type breast cancer of 37-year-old woman. A. Right craniocaudal mammography shows 3 cm-sized hyperdense mass with an irregular shape and obscured margin (arrows) on the right outer breast. B. Ultrasonography shows 3.4 cm-sized hypoechoic mass with an oval shape and circumscribed margin with a posterior enhancement (arrows) in the right 9 o'clock direction. C. Axial contrast-enhanced T1-weighted MR image with fat suppression shows a 3.5 cm-sized mass with an oval shape, circumscribed margin and rim enhancement (arrows) in the right outer center breast.

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  Fig. 3. Human epidermal growth factor receptor-2 enriched type breast cancer of 38-year-old woman. A. Left mediolateral oblique mammography shows a 9-cm area of segmental fine linear microcalcifications (arrows). B. Ultrasonography shows more than 5 cm-sized heterogeneous echoic mass with an irregular shape and calcifications (arrows) in the left 5 o'clock direction. C. Axial contrast-enhanced T1-weighted MR image with fat suppression shows a 7-cm area of non-mass enhancement with segmental distribution and clustered ring internal enhancement pattern (arrows) on the left lower outer breast.

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