An institutional review of tumour biology of breast cancer in young Nepalese women
AbstractIntroduction: Breast cancers in <40 years of age group usually presents with aggressive biology and has poor prognosis. The aim of this study was to see clinic-pathological and hormone receptors of breast cancers in young women and compare with less than 40 year age group.Methods : Prospective analysis of 97 breast cancer in patients less than 40 years out of total 373 patients (26%) over a period of 8 years (2007 Jan to 2014 Dec) was carried out at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.Result: Among the young women diagnosed with breast cancer, the mean age was 34.5±6.2 years. Mean tumour size was larger in younger women (5±2.5 vs 4.5±2.4 cm). Locally advanced disease was higher in younger patients (55% vs 47%). Lymphatic and vascular invasions were higher (63% vs 35% and 40% vs 25%). Grade II and III tumours was higher (56% vs 25%). ER, PR and HER2 positivity was detected in 46.9%, 48.9% and 28.9%, respectively. Significant lower ER/or PR expression (34.5% vs 54%) was seen in younger women, p=.002.Triple negative tumours (ER-, PR- and HER2-ve) was proportionately higher in younger patients (23% vs 13.7%, p=.043).Conclusions: Young Nepalese women presents one quarter of all female breast cancers, more frequently locally advanced with aggressive tumour biology like ER/PR negative and triple negative breast cancers.
2. Freedman RA, Partridge AH. Management of breast cancer in very young women. Breast,2013;2:176-9
3. Stewart BW, Wild C; International Agency for Research on Cancer; World Health Organization. World Cancer Report 2014. Geneva: World Health Organization; 2014
4. Brinton LA, Sherman ME, Carreon JD, Anderson WF. Recent Trends in Breast Cancer Among Younger Women in the United States. JNCI Journal of the National Cancer Institute. 2008;100:1643-1648.
5. Figueroa JD, Brinton LA. Unraveling Genes, Hormones, and Breast Cancer.JNCI Journal of the National Cancer Institute. 2012;104:641-642.
6. Barber MD, Jack W, Dixon JM. Diagnostic delay in breast cancer. Br J Surg 2004;91:49-53
7. Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: Clinicopathological features and biological specificity. Breast 2003;12:247-50
8. Barber MD, Jack W, Dixon JM. Diagnostic delay in breast cancer. Br J Surg 2004;91:49-53.
9. Friedman LC, Kalidas M, Elledge R, Dulay MF, Romero C, Chang J, et al. Medical and psychosocial predictors of delay in seeking medical consultation for breast symptoms in women in a public sector setting. J Behav Med 2006;29:327-34
10. Gurleyik G, Gurleyik E, Aktekin A, Aker F. Preoperative Assessment of the Axilla by Surgeon Performed Ultrasound and Cytology in Patients With Breast Cancer. Journal of Clinical Medicine Research. 2015;7:440-445.
11. John S Meyer, Consuelo Alvarez, Clara Milikowski, Neal Olson, Irma Russo,Jose Russo, Andrew Glass, Barbara A Zehnbauer:Breast carcinoma malignancy grading by Bloom–Richardson system vs proliferation index: reproducibility of grade and advantagesof proliferation index. Modern Pathology 2005,18:1067–1078.
12. Speirs V, Kerin MJ: Prognostic significance of oestrogen receptor beta in breast cancer. Br J Surg 2000, 87:405-409.
13. Donegan WL: Tumor-related prognostic factors for breast cancer. CA Cancer J Clin 1997, 47:28-51
14. Skoog L, Humla S, Axelsson M, Frost M, Norman A, Nordenskjold B, Wallgren A: Estrogen receptor levels and survival of breast cancer patients. A study on patients participating in randomized trials of adjuvant therapy. ActaOncol 1987, 26:95-100
15. Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL: Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 1987, 235:177-182.
16. Anders C, Carey LA: Understanding and treating triple-negative breast cancer. Oncology.2008, 22:1233-1239.
17. Irvin WJ Jr, Carey LA: What is triple-negative breast cancer? Eur J Cancer.2008 44:2799-2805.
18. Rakha EA, Reis-Filho JS, Ellis IO: Basal-like breast cancer: A critical review. J Clin Oncol.2008, 26: 2568-2581.
19. Han-Byoel Lee1, Wonshik Han. Unique Features of Young Age Breast Cancer and Its Management. J Breast Cancer 2014; 17: 301-307
Copyright and Open Access Policy
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
JSSN applies the Creative Commons Attribution (CC BY) license to all works we publish. Under the CC BY license, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, distribute, and/or copy articles in JSSN, so long as the original authors and source are cited. No permission is required from the authors or the publishers.
Article by JSSN is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.jssn.org.np/index.php?journal=jssn.