Stratification of palpable and nonpalpable breast cancer by method of detection and age.

BACKGROUND: Methods used to diagnose breast cancer in women under the age of 50 years are somewhat controversial. To determine the relationship between type and stage of breast cancer, clinical presentation, and age, we reviewed breast cancer diagnosed at our institution during a recent 3-year period.
METHODS: Records from 589 consecutive excisional biopsies and 372 needle placement biopsies performed over a 3-year period were reviewed. Carcinomas were staged according to the TNM system and results compared using chi 2.
RESULTS: Breast carcinoma was diagnosed in 118 women during the study period, 33% in patients under 50 years of age. Breast cancer diagnosed by mammography in all age groups was more likely to be noninvasive than that diagnosed by physical examination (p < 0.05). The few invasive cancers diagnosed by mammography in women under age 50 were lower in stage than those diagnosed by physical examination, although not by a statistically significant amount (p = 0.125). Breast cancer diagnosed by mammography in women 50 years and older was significantly lower in stage than that diagnosed by physical examination (p < 0.05).
CONCLUSIONS: Invasive carcinoma detected as a nonpalpable lesion by mammography was earlier in stage than invasive carcinoma detected by physical examination, including in women under 50 years of age, although the number of invasive cancers detected in younger women was quite small. The role of mammography in this younger age group remains to be defined.