2008, Number 06
<< Back Next >>
Ginecol Obstet Mex 2008; 76 (06)
Comparative study of clinical and pathological features of breast cancer in women with 40 years old an younger vs 70 years old and older
Cuan MJR, Mainero RFE, Aguilar GIU, Bernechea MA, Buenrostro PMA, Burgos PI, Cortés HAEÁ, Burguete VJJ
Language: Spanish
References: 17
Page: 299-306
PDF size: 239.69 Kb.
ABSTRACT
Background: Invasive breast cancer is the most common neoplasia in women attended at IMSS health system since 2004.
Objective: To compare clinical and radiological characteristics on initial appraisal, as well as surgical treatment, pathological features and adjuvant treatment in women with primary breast cancer of 40 years old and younger
vs 70 years old and older.
Material and method: Clinical, radiological and pathological data of 150 patients with breast cancer treated at Hospital de ginecoobstetricia Luis Castelazo Ayala, from January 2003 to June 2006 were collected, and after divided in two groups:
1) patients with 40 years old and younger (
n = 50), and
2) patients with 70 years old and older (
n = 100).
Results: Tumoral size and radiological characteristics were similar in both groups. Group 1 and group 2 had 22 and 13%, respectively, of family history of breast cancer. Fine needle biopsy has positive predictive value of 50% for group 1, and 36% for group 2. Conservative surgery was less common at group 2. Most frequent histological type in both groups was infiltrating ductal carcinoma, followed by infiltrating lobular carcinoma, most common in older women (19
vs 12%), and we found more well differentiated ductal carcinomas in the group of 70 years old and older (12
vs 4%). Seventy-six percent of group 1 and 75% of group 2 were classified as early stage breast cancer (stages I and II). Cytotoxic therapy was offered mostly to group 1, 92
vs 35%. Radiotherapy (80
vs 59%), and hormonal therapy was given only to 56% of group 1
vs 80% of group 2.
Conclusions: Clinical and staging features were similar in both groups. Family history was more influential to group 1. Fine needle biopsy has a low positive predictive value for diagnostic. Well-differentiated carcinomas were higher in patients of group 2, and group 1 had more high-grade carcinomas. There was a trend to perform more conservative surgery at group 1, as well as they underwent more adjuvant chemotherapy and radiotherapy. Use of hormonal therapy was more common at group 2.
REFERENCES
Rodríguez S, Capurso M. Epidemiología del cáncer de mama. Ginecol Obstet Mex 2006;74(11):585-93.
Mainero RF, Bernechea MA, Aguilar GU, Vargas SJM. Edad, etapa clínica y tipo histológico del carcinoma mamario en la Gineco 4 IMSS. Rev Mex Mastol 2007;1:21-26.
Walter RA, Lees E, Web MB, Dearing SJ. Breast carcinomas occurring in young women (< 35) are different. Br J Cancer 1996;7(4):1796-800.
Adami HO, Malker B, Holmberg L, Persson I, Stone B. The relation between survival and age at diagnosis in breast cancer. N Engl J Med 1986;315(9):559-63.
Chung M, Chang HR, Bland KI, Wanebo HJ. Younger women with breast carcinoma have a poorer prognosis than older women. Cancer 1996;77(1):97-103.
Kollias J, Elston CW, Ellis IO, Robertson JF, Blamey RW. Early-onset breast cancer–histopathological and prognostic considerations. Br J Cancer 1997;75(9):1318-23.
Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 1996;78(8):1838-43.
Swanson GM, Lin CS. Survival patterns among younger women with breast cancer: the effects of age, race, stage, and treatment. J Natl Cancer Inst Monogr 1994;(16):69-77.
Velentgas P, Daling JR, Malone KE, Weiss NS, et al. Pregnancy after breast carcinoma. Cancer 1999;85(11):2424-32.
Gelber S, Coates AS, Goldhirsch A, Castiglione-Gertsch M, et al. Effect of pregnancy on overall survival following the diagnosis of early stage breast cancer. J Clin Oncol 2001;19:1671-5.
Blumenfeld Z, Dann E, Avivi I, Epelbaum R, Rowe JM. Fertility after treatment for Hodgkin’s disease. Ann Oncol 2002;13(Suppl 1):138-47.
Rugo HS. Management of breast cancer diagnosed during pregnancy. Curr Treat Options Oncol 2003;4(2):165-73.
Berry DL, Theriault RL, Holmes FA, Parisi VM, Booster DJ, et al. Management of breast cancer during pregnancy using a standardized protocol. J Clin Oncol 1999;17(3):855-61.
Jemal A, Murray T, Samuels A, Ghafoor A, et al. Cancer statistics, 2003. CA Cancer J Clin 2003;53(1):5-26.
Diab SG, Elledge RM, Clark GM. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 2000;92(7):550-6.
Hughes KS, Schnaper L, Berry D, Cirrincione C, et al. Comparison of lumpectomy plus tamoxifen with and without radiotherapy (RT) in women 70 years of age or older who have clinical Stage I, estrogen receptor positive (ER+) breast carcinoma. Proc ASCO 2001;20:24A.
Scopa CD, Koukouras D, Spiliotis J, Harkoftakis J, et al. Comparison of fine needle aspiration and Tru-Cut biopsy of palpable mammary lesions. Cancer Detect Prev 1996;20(6):620-4.