ABSTRACT
Introduction:
Breast cancer (BC) centers are increasingly attending "ultra-young"
women (UYW)
patients (≤ 30 years),
who usually present aggressive
tumors and
face specific problems.
Objectives:
We aimed to examine a multicentric casuistic view, addressing clinicopathological and molecular characteristics of BC, as well as
therapeutic measures and oncological outcomes.
Methods:
A retrospective multicentric
observational study of UYW with infiltrating BC was carried out. The
patients were treated between the period from January 1991 to December 2019. Clinical, epidemiological, morphological, molecular,
therapeutic and outcomes data were collected from the charts.
Results:
A total of 293
patients were followed for a average period of 34.5 months.
Nulliparity was referred by 204
women (75.5%), of whom 81 (37.1%) were
overweight or obese. Positive
family history in first-degree
relatives was verified in 25
patients (10.1%). Only 30
patients underwent genetic tests, which revealed inherited pathogenic
mutations in 12 of them (37.5%). Thirty-two (32) cases were classified as T1 at
diagnosis (10.9%), while "De novo" stage IV was found in 29
patients (9.8%).
Mastectomy was performed in 175
women (70.2%), quadrantectomy in 46
women (18.4%), and mammary adenectomies in 28
women (11.2%), of which 149 cases were reported after
neoadjuvant chemotherapy (56.0%). A total of 111
patients had at least one positive
lymph node (47.4%). The rate of
patients with
estrogen receptor-negative was 32.7% and the rate of
patients with
Human Epidermal Growth Factor Receptor 2-positive (HER2-positive) was 25%. The frequency of
Luminal A
neoplasias was 16.6%,
Luminal B/HER2- was 35.9%,
Luminal B/HER2+ was 15.1%, HER2 overexpressed was 9.3%, and Basal was 22.9%. Taking into account the outcomes, 173
patients were alive without
disease (65.7%); 23
patients were alive with any form of
recurrence (8.7%); and 67
patients (25.4%) evolved to BC deaths.
Conclusions:
It was concluded that UYW with BC are commonly diagnosed at advanced stages, present adverse morphological and molecular
parameters, and have unfavorable
prognosis.