Publication:

Study of carcinoma breast in women under 40 years of age

Background Carcinoma breast is the commonest malignancy in females worldwide. Although a disease of postmenopausal age, occurrence in young age is a poor prognostic factor. Hence this study was undertaken to study clinical presentation, extent of disease, treatment modalities, histopathological typing and grading of carcinoma breast in females upto 40 years and to compare tumor characteristics between very young (≤30 years) and young (30- 40 years) patients.

Methods This was a hospital based observational study conducted at Department of Surgery, GMC Nagpur, from July 2009 to November 2011. All cytologically or histologically proven cases of carcinoma breast in females ≤40 years of age giving consent were included. All the patients were evaluated by detailed clinical evaluation and investigated, treated with different modalities according to clinical stage and were followed up for a period of two months. Data was collected and tabulated into a master sheet and statistical tests were applied to test the significance of association.

Results Mean age was 35.24 years (19-40 years), 12 patients being under 30 years (very young). Mean duration of presentation 3.08 months. Mean lump size was 5.32 cm, 56% had lump >5 cm. Only 1/3rd of patients had EOBC, 2/3rd had LOBC/LABC. FNAC was 87% sensitive, ER positivity was low. All patients received multimodality treatment, 84% underwent mastectomy and none underwent BCT. We report two deaths. Very young group showed more incidence of node positivity, advanced stage of the disease and positive margin of resected specimen than young age group but had no significant difference with respect to tumor size and histopathological characteristics. Nulliparity, breast feeding and protective effect of early age at 1st pregnancy when were independently tested in operable and advanced staged cancer groups no statistically significant association was found.

Conclusions Carcinoma of breast in young females, although less common, is an aggressive disease. In India more patients present in advanced stage precluding BCT. Early diagnosis can improve outcome.