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The pattern of histopathological presentation in younger (< 40 years) and elder age(>40 years) breast cancer patients: a retrospective study from a tertiary cancer center

Subrat Kumar Samantara, Kusumbati Besra, Padmalaya Devi, Sagarika Samantaray, Sashibhusan Dash.

Abstract
Introduction: Breast cancer among young women is found to have a more aggressive behaviour and trends to be diagnosed at an advanced stage but the reason still remains unclear. This study aims to evaluate the clinicohistopathological characteristics of breast carcinoma ≤40 years in comparison to that over >40 years ago. Methods: Hospital-based retrospective study was done over a period of three years from January 2017 to December 2019 at Acharya Harihar Post Graduate Institute of Cancer, Cuttack. Patients who were diagnosed with breast carcinoma and subsequent underwent breast surgery were included. The cases were divided into a “young” ≤40 years group and an “older” >40 years group. Clinicohistopathological parameters such as age, sex, tumour site, tumour size, tumour type, tumour grade, lymphovascular invasion (LVSI), perineural invasion (PNI), presence of tumour necrosis, T stage, nodal positivity, hormonal expression were retrieved from the hospital record. Results: A total of 589 patients were included during this study period, out of which 166 (28.18%) were ≤40 years and 423 (71.81%) were >40 years ago. Compared with the elderly patients,89 (53.61%) breast cancer in young patients were poorly differentiated(P=0.0000606; significant). One hundred and sixteen patients (69.87%) presented with T3/T4 as compared to 240 (56.73%)patients in the above >40 years age group. (P= 0.0033; significant). The double-positive expression of the estrogen receptor (ER) and PR (i.e., ER+/PR+) in the two groups were 63 (37.95%) and 225 (53.19%) respectively. However, 46 (27.71)% of patients were triple-negative in the ≤40 years age group versus 84 (18.85%) in the >40 years age group. Conclusion: Younger age patients were associated with high tumour grade, stage, PNI, LVSI, tumour necrosis, the negative status of progesterone (PR) and estrogen receptor (ER), and triple-negative subtype of the tumour. 

Key words: Breast cancer, young patients, histopathological characteristics, prognostic factors



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