Comparison of adverse breast cancer characteristics in very young (less than 35 years ) and less young (35-45 years) women in Ostad Alinasab Hospital in north west of IRAN (TABRIZ ).

Background: Up to 3%of breast cancer cases occur in women younger than 35 years in west world (greater than 14% in IRAN).Studies have suggested an association between breast cancer at a young age, poorer outcome, and adverse clinical and pathologic characteristics. It is unclear whether age is an independent prognostic factor. Objectives: To characterize the prognostic significance of young age at diagnosis through comparison of disease characteristics of very young (less than 35 years) and less young (35-45 years old) premenopausal patients. Methods: Consecutive patients with breast cancer up to 45 years old in time of diagnosis, treated in Ostad alinasab hospital and our provide clinic in north west of IRAN (TABRIZ) between October 2002-november2o13were identified and their files reviewed(453 patients) .This cohort was identified as very young (less than 35 years old or group I) and was compared with a group of less- young (35-45 years old or group II ) patients .The clinicopathologic characteristics and survival data were compared. . Results: Mean age were 32/5 years in group I (19-35 years) and 42years in group II (35-45 years).The form of pathology in group I were invasive intraductal carcinoma in 83% and basal like in 7% and invasive intra lobular carcinoma in 8% and other type in 2% of cases, but in group II ,85% invasive intra ductal and 5% basal like and 8%intra lobular and 2% other type. In group I 24%were multifocal tumor but 17% in group II .The size of tumor or T in group I were 18% T1 and 47%T2 and 27%T3 and 8%T4 but in group II , T1 in 28% and T2 in47% and T3 in 20% and T4 in 5%were seen. Grade of tumors in group I were G3 or high grade in 71% and G2 in 17% and G1 in 12%, but in group II , G3 in 52% and G2 in 35% and G1 in 13%. Lymphovascular invasion was seen in 65% of group I but in 49% of group II. Axillary lymph node involvement was seen in 61% of group I but in 49% of group II. Stage of disease in the time of diagnosis group I were (20%stage I, 49%stage II, 21% stage III, 10%in stage IV) but in group II (24% stage I , 50% stage II, 18% stage III, 7% stage IV ).59% of patients In group I and 72% of group II were ER+, 52% of patients in group I and 59% in group II were PR+.Her2 expression were seen in 39% of group I but in 25% of group II. 35% of patients in group I but 21% in group II were triple negative. Median follow up of patients in two groups after treatment was 60 month. Five years survival in very young patients was71%.but 79% in group II. Conclusions: Very young age among Iranian women with breast cancer is associated with higher stage at diagnosis, adverse pathologic characteristics (high grade, lymphatic and vascular invasion, ER negativity, triple negativity, and…) and adverse outcome when compared with less young patients, but probably age is not an independent prognostic factor for survival.

Keywords:

Breast Cancer , Sialic Acid , Sialyltransferas , Metastatic