Mammographic and Ultrasonographic Findings in Women with Breast Cancer Diagnosed before the Age of 40 Years
Keywords:
mammography, breast ultrasonography, clinicopathology, breast cancer, before 40 yearsAbstract
ABSTRACT
Objective: The purpose was to evaluate clinical features, imaging findings, and clinicopathological aspect of breast cancer under the age of 40 years in Chaophrayayommarat hospital.
Method: This retrospective study included 51 patients under 40 years old with pathological diagnosis of breast cancer between September 2014 to August 2019. Thirty-nine patients were investigated by both mammography and ultrasonography. The remaining twelve performed only ultrasonography. The clinical features, imaging findings, and clinicopathological aspects of breast cancer under the age of 40 years were evaluated.
Results: The mean age at diagnosis of breast cancer was 35 years. Only 4 patients (7.8%) had a family history of breast cancer in first degree relative. Most of tumors presented with palpable breast mass (88.2%). The most common histological type was invasive ductal carcinoma (82.3%) and 88.2% of tumors were high grade tumors. The ultrasonography showed a higher detection rate of malignant tumors in younger age than mammography (100% compared to 92%). The predominant features suggested of malignant tumors were irregular shape, microlobulated border, hyperdensity of tumor on mammography and hypoechogenicity of tumor on ultrasonography. The tumor size measured by mammography and ultrasound as correlated with pathological size was no statistically significant difference.
Conclusion: Breast cancer diagnosed in women before 40 years usually presents with a self-detected palpable mass. Ultrasonography is the main modality and has slightly superior detection rate for diagnosis of breast cancer in young women than mammography. Most cases of breast cancer presented more aggressive biological behavior. Awareness of imaging and clinicopathological findings of breast cancer in young women is essential for identifying preventive approaches and helps radiologists to make an early and accurate diagnosis.
References
Cholatip W, Lupreechaed A, Lertsittichai P. Ultrasonographic and mammographic findings in malignant tumors of the breast in young women. The Asean Journal of Radiology. 2012: 18(1): 16-25.
Kuhaprema T, Srivatanatul, Attasara P, et al. Cancer in Thailand volume 5. Bangkok: Ministry of public health; 2010: 47-51.
National Cancer Institute Department of Medical Services Ministry of Public health Thailand. Hospital-based Cancer Registry 2018. Bangkok: Information Technology Division National Cancer Institute; 2017: 63-7. (In thai)
Gnerlich JL, Deshpande AD, Jeffe DB, et al. Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early stage disease. J Am Coll Surg. 2009; 208(3): 341-7. doi: 10.1016/j.jamcollsurg.2008.
001.
Durhan G, Azizova A, Önder Ö, et al. Imaging findings and clinicopathologicalr correlation of breast cancer in women under 40 years old. Eur J Breasts health. 2019; 15(3): 147-52.
Eugênio DSG, Souza JA, Chojniak R, et al. Breast cancer diagnosed before the 40 years: imaging findings and correlation with histology and molecular subtype. Appl Cancer Res. 2017; 37(16): 1-7. doi: 10.1186/s41241-017-0019-7.
Berg WA, Gutierrez L, Nessaiver MS, et al. Diagnosis accuracy of mammography, clinical examination, US and MR imaging in preoperative assessment of breast cancer. Radiology. 2004; 233(3): 830-49. doi: 10.1148/radiol.2333031484.
Shaw de Paredes E, Marsteller LP, Eden BV. Breast cancers in women 35 years of age and younger: mammographic findings. Radiology. 1990; 177(1): 117-9. doi: 10.1148/radiology.177.1.2399309.
Magny SJ, Shikhman R, Keppke AL. Breast, Imaging, Reporting and Data System (BI RADS). 5th ed. Island: StatPearls Publishing; 2013.
An YY, Kim SH, Kang BJ, et al. Breast cancer in very young women (< 30 years): Correlation of imaging features with clinicopathological features and immunochemical subtypes. Eur J Radiol. 2015: 84(10): 1894-902. doi: 10.1016/j.ejrad.2015.07.002.
Standford JL, Greenburg RS. Breast cancer incidence in young women by estrogen receptor status and race. Am J Public Health. 1989; 79(1): 71-3. doi: 10.2105/ajph.79.1.71
Kolb TM, Lichy J, Newhouse JH. Comparison of the performance of the screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. Radiology. 2002; 225(1): 165-75. doi: 10.1148/radiol.2251011667.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
