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. 2019 Nov 22:11:9891-9897.
doi: 10.2147/CMAR.S229337. eCollection 2019.

Clinicopathological Characteristics And Treatment Outcomes Of Breast Cancer Among Adolescents And Young Adults In A Developing Country

Hikmat Abdel-Razeq  1   2 , Hanan Almasri  3 , Fadwa Abdel Rahman  3 , Hazem Abdulelah  1 , Mahmoud Abu Nasser  1 , Mourad Salam  1 , Ammer Al-Dairi  3 , Osama Natour  4 , Dalia Rimawi  5
Affiliations

Clinicopathological Characteristics And Treatment Outcomes Of Breast Cancer Among Adolescents And Young Adults In A Developing Country

Hikmat Abdel-Razeq et al. Cancer Manag Res. .

Abstract

Purpose: Compared to Western societies, breast cancer diagnosis in our region is usually made at a younger age and at a more advanced stage. Breast cancer in younger patients tends to be more aggressive, and may result in a higher likelihood of long-term treatment-related toxicity and unique psychosocial problems. This study highlights the clinicopathological features and treatment outcomes in this age-group in a developing country like ours.

Methods: Consecutive patients aged 40 years or younger with a pathologically confirmed diagnosis of breast cancer treated and followed up at our institution were included. Medical records and hospital databases were searched for patients' characteristics and treatment outcomes.

Results: A total of 417 patients were enrolled. Median age at diagnosis was 35 (21-40) years. On presentation, 63 (15.1%) patients had metastatic disease, 50 (79.4%) with visceral metastasis. Patients with nonmetastatic disease had poor pathological features, including node-positivity (66.9%), grade III (51.4%), lymphovascular invasion (48.6%) and positive HER2 (31.5%). Breast-conserving surgery was performed on 32.9%, and only 36.5% of women had breast-reconstruction surgery. At a median follow-up of 59 months, 5-year overall survival for the whole group was 72%: 84% for nonmetastatic and 13% for those with metastatic disease. On Cox regression, nodal metastasis (adjusted HR 3.46, 95% CI 1.48-8.10; p=0.004) and grade III disease (HR 1.97, 95% CI 1.14-3.39; p=0.015) were associated with poor outcome.

Conclusion: Adolescents and young Jordanian adults with breast cancer present with more advanced-stage disease and more aggressive pathological features that reflect poorly on treatment outcomes.

Keywords: AYA; adolescents and young adults; breast cancer; developing countries; late presentation.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overall survival (n=417). (A) Whole group (M0 and M1); (B) node-positive versus node-negative (M0 patients); (C) grade I/II versus grade-III (M0 patients); (D) age >30 versus ≤30 years (M0 patients).
Figure 2
Figure 2
Disease-free survival for the nonmetastatic patients (n=354). (A) Node-positive versus node-negative; (B) grade I/II versus grade III; (C) age >30 versus ≤30 years.
See this image and copyright information in PMC

References

    1. Al-Sayaideh A, Nimri O, Arqoub K, Al-Zaghal M, Halasa W. Cancer Incidence in Jordan-2012. Ministry of Health, Non-Communicable Diseases Directorate, Jordan Cancer Registry; 2012. Available from: http://www.moh.gov.jo/Echobusv3.0/SystemAssets/a05a084b-3781-4979-a217-2.... Accessed July26, 2019.
    1. Jordan Cancer Registry. Cancer incidence in Jordan. 2015. Available from: http://www.moh.gov.jo/Pages/viewpage.aspx?pageID=240. Accessed July05, 2019.
    1. Johnson E. Breast cancer racial differences before age 40-implications for screening. J Nat Med Assoc. 2002;94:149–156. - PMC - PubMed
    1. Korde LA, Partridge AH, Esser M, Lewis S, Simha J, Johnson RH. Breast cancer in young women: research priorities. A report of the young survival coalition research think tank meeting. J Adolesc Young Adult Oncol. 2015;4(1):34–43. doi:10.1089/jayao.2014.0049 - DOI - PubMed
    1. Rosenberg SM, Partridge AH. Management of breast cancer in very young women. Breast. 2015;24(Suppl 2):S154–S158. doi:10.1016/j.breast.2015.07.036 - DOI - PubMed