Abstract
Aim: Breast cancer is the most common malignancy among women, with poorer survival outcomes in younger patients. Adolescents and young adults (AYAs), typically defined as women under 40–45 years, often present with aggressive tumor subtypes and advanced-stage disease. This study analyzes the epidemiological and demographic characteristics of breast cancer patients under 45 at our center to provide insights into this high-risk group.
Materials and Methods: This retrospective study analyzed 90 breast cancer patients aged 45 years or younger, diagnosed at our clinic between January 2015 and December 2023.
Results: A total of 90 female breast cancer patients, with a median age of 39 years (25–45), were analyzed in our study. At diagnosis, 27.8% were in early stages (stage 1–2), 57.8% had locally advanced disease (stage 3), and 14.4% were de novo metastatic. Axillary lymph node positivity was observed in 72.2%, and invasive ductal carcinoma was the most common histological subtype (61.1%).Tumor grades 2 and 3 were identified in 24.4% and 56.7% of patients, respectively. Hormonal receptor positivity was detected in 86.7% of patients, HER2 positivity in 41.1%, and BRCA mutation in 20%. Metastases were most commonly found in the bone (20%) and lung (12.2%).
Conclusion: Our study underscores the aggressive nature of breast cancer in young patients, marked by advanced stages and high-risk features at diagnosis. These findings highlight the need for enhanced early detection and personalized treatment approaches to improve outcomes for young breast cancer patients.
Ethical Statement
The study was conducted according to the principles of the Declaration of Helsinki and approval was obtained from the ethics committee of Ankara Etlik City Hospital on April 24, 2024, with approval number 2024-322.
Supporting Institution
The authors received no financial support for the research and/or authorship of this article.
References
- Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2024;74(3):229-263.
- Anders CK, Fan C, Parker JS, et al. Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes? Journal of clinical oncology. 2011;29(1):e18-e20.
- Bleyer A, Barr R, Hayes-Lattin B, et al. The distinctive biology of cancer in adolescents and young adults. Nature Reviews Cancer. 2008;8(4):288-298.
- DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69(6):438-451.
- Özmen V. Breast cancer in Turkey: clinical and histopathological characteristics (analysis of 13.240 patients). The journal of breast health. 2014;10(2):98.
- Chung W-P, Lee K-T, Chen Y-P, et al. The prognosis of early-stage breast cancer in extremely young female patients. Medicine. 2021;100(1):e24076.
- El Saghir NS, Seoud M, Khalil MK, et al. Effects of young age at presentation on survival in breast cancer. BMC cancer. 2006;6:1-8.
- Tichy JR, Lim E, Anders CK. Breast cancer in adolescents and young adults: a review with a focus on biology. Journal of the National Comprehensive Cancer Network. 2013;11(9):1060-1069.
- Anders C, Hsu S, Acharya C, et al. Molecular signatures characterize early stage breast cancer arising in young women and have prognostic and therapeutic implications independent of ER status. Journal of Clinical Oncology. 2007;25(18_suppl):522-522.
- Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH. Breast cancer in adolescent and young adult women under the age of 40 years. JCO oncology practice. 2021;17(6):305-313.
- Anastasiadi Z, Lianos GD, Ignatiadou E, Harissis HV, Mitsis M. Breast cancer in young women: an overview. Updates in surgery. 2017;69:313-317.
- Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA. Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. Journal of the American College of surgeons. 2009;208(3):341-347.
- Culha Y, Davarci SE, Ünlü B, Özaşkin D, Demir H, Baykara M. Comparison of clinicopathological and prognostic features of breast cancer patients younger than 40 years and older than 65 years. Discover Oncology. 2024;15(1):1-14.
- Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. Journal of clinical oncology. 2008;26(20):3324-3330.
- Cancello G, Maisonneuve P, Rotmensz N, et al. Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (< 35 years) with operable breast cancer. Annals of oncology. 2010;21(10):1974-1981.
- Oflazoglu U, İriağaç Y, Küçükzeybek Y, et al. Prognostic Value of De-Ritis Ratio in Adolescents and Young Adult Patients with Breast Cancer. Acta Oncologica Turcica. 2020;53:37-45.
- Partridge AH, Hughes ME, Warner ET, et al. Subtype-dependent relationship between young age at diagnosis and breast cancer survival. Journal of Clinical Oncology. 2016;34(27):3308-3314.
Abstract
Amaç: Meme kanseri, kadınlar arasında en sık görülen malignitedir ve genç hastalarda sağkalım oranları daha düşüktür. Genellikle 40–45 yaş altındaki kadınlar bu grupta tanımlanır ve sıklıkla agresif tümör alt tipleriyle birlikte ileri evre hastalıkla tanı alırlar. Bu çalışma, merkezimizde takip edilen 45 yaş altındaki meme kanseri hastalarının epidemiyolojik ve demografik özelliklerini inceleyerek yüksek riskli bu grup hakkında daha fazla bilgi sağlamayı amaçlamaktadır.
Gereç ve Yöntem: Çalışmamızda Ocak 2015 ile Aralık 2023 tarihleri arasında kliniğimizde tanı alan 45 yaş ve altındaki 90 meme kanseri hastasını analiz ettik.
Bulgular: Çalışmamızda, ortalama yaşı 39 (25–45) olan toplam 90 kadın meme kanseri hastasını analiz ettik. Tanı anında hastaların %27,8’i erken evrede (evre 1–2), %57,8’i lokal ileri evrede (evre 3) ve %14,4’ü de novo metastatik evredeydi. Hastaların %72,2’sinde aksiller lenf nodu pozitifliği gözlemlendi ve en sık görülen histolojik alt tip invaziv duktal karsinom (%61,1) idi. Tümör grade’leri 2 ve 3 olan hastaların oranları sırasıyla %24,4 ve %56,7 olarak belirlendi. Hormonal reseptör pozitifliği hastaların %86,7’sinde, HER2 pozitifliği %41,1’inde ve BRCA mutasyonu %20’sinde saptandı. Metastazlar en sık kemik (%20) ve akciğerde (%12,2) görüldü.
Sonuç: Çalışmamız, genç hastalarda meme kanserinin agresif doğasını, tanı anında ileri evre ve yüksek riskli özelliklerle belirgin bir şekilde ortaya koymaktadır. Bu bulgular, genç meme kanseri hastalarının tedavi sonuçlarını iyileştirmek için geliştirilmiş erken teşhis yöntemlerine ve kişiselleştirilmiş tedavi yaklaşımlarına olan ihtiyacı vurgulamaktadır.
Ethical Statement
The study was conducted according to the principles of the Declaration of Helsinki and approval was obtained from the ethics committee of Ankara Etlik City Hospital on April 24, 2024, with approval number 2024-322.
Supporting Institution
The authors received no financial support for the research and/or authorship of this article.
References
- Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2024;74(3):229-263.
- Anders CK, Fan C, Parker JS, et al. Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes? Journal of clinical oncology. 2011;29(1):e18-e20.
- Bleyer A, Barr R, Hayes-Lattin B, et al. The distinctive biology of cancer in adolescents and young adults. Nature Reviews Cancer. 2008;8(4):288-298.
- DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2019. CA: a cancer journal for clinicians. 2019;69(6):438-451.
- Özmen V. Breast cancer in Turkey: clinical and histopathological characteristics (analysis of 13.240 patients). The journal of breast health. 2014;10(2):98.
- Chung W-P, Lee K-T, Chen Y-P, et al. The prognosis of early-stage breast cancer in extremely young female patients. Medicine. 2021;100(1):e24076.
- El Saghir NS, Seoud M, Khalil MK, et al. Effects of young age at presentation on survival in breast cancer. BMC cancer. 2006;6:1-8.
- Tichy JR, Lim E, Anders CK. Breast cancer in adolescents and young adults: a review with a focus on biology. Journal of the National Comprehensive Cancer Network. 2013;11(9):1060-1069.
- Anders C, Hsu S, Acharya C, et al. Molecular signatures characterize early stage breast cancer arising in young women and have prognostic and therapeutic implications independent of ER status. Journal of Clinical Oncology. 2007;25(18_suppl):522-522.
- Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH. Breast cancer in adolescent and young adult women under the age of 40 years. JCO oncology practice. 2021;17(6):305-313.
- Anastasiadi Z, Lianos GD, Ignatiadou E, Harissis HV, Mitsis M. Breast cancer in young women: an overview. Updates in surgery. 2017;69:313-317.
- Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA. Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. Journal of the American College of surgeons. 2009;208(3):341-347.
- Culha Y, Davarci SE, Ünlü B, Özaşkin D, Demir H, Baykara M. Comparison of clinicopathological and prognostic features of breast cancer patients younger than 40 years and older than 65 years. Discover Oncology. 2024;15(1):1-14.
- Anders CK, Hsu DS, Broadwater G, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. Journal of clinical oncology. 2008;26(20):3324-3330.
- Cancello G, Maisonneuve P, Rotmensz N, et al. Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (< 35 years) with operable breast cancer. Annals of oncology. 2010;21(10):1974-1981.
- Oflazoglu U, İriağaç Y, Küçükzeybek Y, et al. Prognostic Value of De-Ritis Ratio in Adolescents and Young Adult Patients with Breast Cancer. Acta Oncologica Turcica. 2020;53:37-45.
- Partridge AH, Hughes ME, Warner ET, et al. Subtype-dependent relationship between young age at diagnosis and breast cancer survival. Journal of Clinical Oncology. 2016;34(27):3308-3314.
Details
| Primary Language | English |
|---|---|
| Subjects | Solid Tumours |
| Journal Section | Research Article |
| Authors | |
| Publication Date | April 23, 2025 |
| Submission Date | November 18, 2024 |
| Acceptance Date | February 25, 2025 |
| Published in Issue | Year 2025 Volume: 11 Issue: 1 |
