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Título

A MULTICENTRIC STUDY ON BREAST CANCER IN ULTRA YOUNG WOMEN: I – A CLINICAL AND EPIDEMIOLOGIC LANDSCAPE

Título em Inglês

A MULTICENTRIC STUDY ON BREAST CANCER IN ULTRA YOUNG WOMEN: I – A CLINICAL AND EPIDEMIOLOGIC LANDSCAPE

Introdução

Introduction. A substantial number of young women (YW) is affected by breast cancer (BC), an important cause of cancer - related deaths in this age range. The definition of a YW in BC context varies in the literature. Considering specific characteristics, such as reproductive factors and hereditary risk, we defined ultra young women (UYW) as women aged 30 years or bellow. Despite that specialized centers are increasingly providing assistance to UYW with BC, important aspects of the disease in this age remain controversial.

Objetivos

Objective. Evaluate clinical and epidemiological characteristics of BC in UYW in the State of São Paulo.

Métodos

Methods. We conducted a multicentric, observational, retrospective study of consecutive BC in UYW patients in 9 Services. Only patients with infiltrating BC aged 30 years or bellow were included. The following data were collected: age, body mass index, parity, hormonal contraception use, history of breast/ovarian cancer in the family, pathological tumor category and clinical staging. Frequency parameters were estimated. The research protocol was approved by the Ethics Committee of all collaborative centers. In formed consent was waived.

Resultados

Results. The study population included 293 patients. Aged varied between 19 and 30 years (mean 27.3; median 28). Considering body weight, we found that 37.1% of the patients were overweighted or obese. 58.6% were current or past HC users. Nulliparity was referred in 44.4%. 246 cases reported family history of BC which was verified in first degree relatives in 37.9%, while 66 patients referred BC in any member of the family. Only 33 patients made a multigene testing panel: pathogenic inherited variants were detected in 37.5%. Remarkably, locally advanced tumors were diagnosed in 57.1%. Tumor sizes at diagnosis were: T1-11.8%, T2-33.8%, T3-31.6% T4-19.9% and T4d-2.9%. Clinical axillary lymph nodes evaluation revealed: N0-35%, N1-42.8%, N2-18.7%, and N3-3.5%. Systemic metastases at diagnosis were observed in 29 cases, that were classified as stage IV “de novo” (9.8%). The metastases sites were multiple in 31%. Clinical staging is showed in figure 1, and the diagnosis at later stages was evident.

Conclusões

Conclusion. An unfavorable landscape, was observed in UYW with BC. We found high rate of advanced neoplasias, with adverse clinical prognostic factors. For changing the present-day scenario, we need to educate the population, enhancing BC awareness and self-body attention since adolescence, and stimulating the adoption of a healthy life-style.

Palavras Chave

Área

EPIDEMIOLOGY, RISK, AND PREVENTION - Epidemiology, risk, and prevention – other