Breast Cancer and Age

Tiffany T Fancher, Jacek J Paszkowiak, Ravi P Kiran, Alpin D Malkan, Niby Mathew, James J O'Campo, Ellen G Polokoff, Stanley J Dudrick
St. Mary's Hospital, Waterbury, CT

Objective: Women under 41 years of age, diagnosed with breast cancer, have unique characteristics compared with their older counterparts.
Design: Retrospective chart review was performed for all women diagnosed with breast cancer between 1994-2003.
Setting: Private community hospital.
Patients: In total, 712 women were diagnosed with breast cancer. Fifty-five (8%) patients were under 41 years of age.
Main Outcome Measures: Demographics, year and method of diagnosis, tumor histology, hormonal receptor status, operation performed, and stage of disease were analyzed. Mann Whitney, Fisher Exact and Chi-Squared tests were used as appropriate.
Results: The principal modality for establishing the breast cancer diagnosis was mammography (49%) in the older patients and breast self examination (76%) in the younger patients (p<0.0001). The mastectomy rate was 17% in the older patient group and 56% in the younger group (p<0.0001). The ER/PR status was similar between the two groups (p=0.58). A significant difference in the stage at presentation was evident between the two groups (p<0.001) as the younger patients presented with more advanced disease.
Conclusions: While breast cancer in older women was primarily diagnosed by mammography, a significant number of women under 41 discovered a palpable mass, thereby causing us to challenge the skepticism expressed recently toward the role of breast self examination. Our data confirm that young women with breast cancer are more likely to present with more advanced stages of the disease compared with older patients. In response to the increasing incidence of young women under 41 years of age diagnosed with breast cancer in recent years, further investigation focused on this age group is indicated.

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