BACKGROUND: Breast cancer in young women is uncommon, but when it does occur it has been reported to have aggressive biological characteristics. The incidence of breast cancer peaks at age 40 in Hong Kong Chinese women, earlier than in Caucasians. This study is the first to report the tumor characteristics and management of breast cancer in Chinese women younger than age 40 and a comparison with their older counterparts. MATERIALS AND METHODS: Demographic and clinicopathologic findings of 1,485 Chinese women with breast cancer seen during the period September 2003 to November 2006 were prospectively recorded, and comparisons were made between those who were under the age of 40 and those 40 years of age and older. These results were then compared with a reference population obtained from the Surveillance, Epidemiology and End Results (SEER) database between 2003 and 2004. RESULTS: 17.6% of the women were younger than 40 years old, and age distribution was significantly different from women in the SEER database. The mean age at menarche was lower in women under age 40 (p < 0.0005), and age at first live birth was also higher (p = 0.017). The rate of first detection by screening mammography was significantly higher among women who were 40 of age and older (p = 0.002). Breast conservation surgery was more commonly performed in the younger age group of Chinese women, particularly when tumor size was less than 2 cm (p = 0.001). A significantly higher proportion of women under age 40 had breast reconstruction (p < 0.001). The majority of women presented with stage 0-II disease, but in the Chinese groups the younger patients presented at a later stage (p = 0.04). Younger women had higher pathological grade and poorly differentiated tumors (p = 0.02), more nodal involvement (p = 0.024), and lymphovascular permeation involvement (p < 0.001). The majority of tumors were ER and PR positive in both groups, but younger women had a higher proportion of cerbB2-positive tumors. CONCLUSION: Chinese women present with breast cancer at an earlier age. Younger women present with more advanced disease and more aggressive tumor characteristics. More ethnic-specific screening protocols and treatment decisions may benefit this group of patients.
BACKGROUND:Breast cancer in young women is uncommon, but when it does occur it has been reported to have aggressive biological characteristics. The incidence of breast cancer peaks at age 40 in Hong Kong Chinese women, earlier than in Caucasians. This study is the first to report the tumor characteristics and management of breast cancer in Chinese women younger than age 40 and a comparison with their older counterparts. MATERIALS AND METHODS: Demographic and clinicopathologic findings of 1,485 Chinese women with breast cancer seen during the period September 2003 to November 2006 were prospectively recorded, and comparisons were made between those who were under the age of 40 and those 40 years of age and older. These results were then compared with a reference population obtained from the Surveillance, Epidemiology and End Results (SEER) database between 2003 and 2004. RESULTS: 17.6% of the women were younger than 40 years old, and age distribution was significantly different from women in the SEER database. The mean age at menarche was lower in women under age 40 (p < 0.0005), and age at first live birth was also higher (p = 0.017). The rate of first detection by screening mammography was significantly higher among women who were 40 of age and older (p = 0.002). Breast conservation surgery was more commonly performed in the younger age group of Chinese women, particularly when tumor size was less than 2 cm (p = 0.001). A significantly higher proportion of women under age 40 had breast reconstruction (p < 0.001). The majority of women presented with stage 0-II disease, but in the Chinese groups the younger patients presented at a later stage (p = 0.04). Younger women had higher pathological grade and poorly differentiated tumors (p = 0.02), more nodal involvement (p = 0.024), and lymphovascular permeation involvement (p < 0.001). The majority of tumors were ER and PR positive in both groups, but younger women had a higher proportion of cerbB2-positive tumors. CONCLUSION: Chinese women present with breast cancer at an earlier age. Younger women present with more advanced disease and more aggressive tumor characteristics. More ethnic-specific screening protocols and treatment decisions may benefit this group of patients.
Authors: Peter C Dubsky; Michael F X Gnant; Susanne Taucher; Sebastian Roka; Daniela Kandioler; Barbara Pichler-Gebhard; Irene Agstner; Michael Seifert; Paul Sevelda; Raimund Jakesz Journal: Clin Breast Cancer Date: 2002-04 Impact factor: 3.225
Authors: A de la Rochefordiere; B Asselain; F Campana; S M Scholl; J Fenton; J R Vilcoq; J C Durand; P Pouillart; H Magdelenat; A Fourquet Journal: Lancet Date: 1993-04-24 Impact factor: 79.321
Authors: Polly Cheung; W K Hung; Catherine Cheung; Amy Chan; T T Wong; Lawrence Li; Sharon W W Chan; K W Chan; Peter Choi; W H Kwan; C C Yau; Emily Y Y Chan; Stephen C K Law; Daisy Kwan Journal: World J Surg Date: 2012-04 Impact factor: 3.352
Authors: Winnie Yeo; Hang-Mei Lee; Amy Chan; Emily Yy Chan; Miranda Cm Chan; Keeng-Wai Chan; Sharon Ww Chan; Foon-Yiu Cheung; Polly Sy Cheung; Peter Hk Choi; Josette Sy Chor; William Wl Foo; Wing-Hong Kwan; Stephen Ck Law; Lawrence Pk Li; Janice Wh Tsang; Yuk Tung; Lorna Ls Wong; Ting-Ting Wong; Chun-Chung Yau; Tsz-Kok Yau; Benny Cy Zee Journal: World J Clin Oncol Date: 2014-12-10