Demographics and Tumor Characteristics of Breast Cancer in Young Women: Evidence of Racial Disparity
C Kinonen, KP Siziopikou. Rush University Medical Center, Chicago, IL; Northwestern University Medical Center, Chicago, IL
Background: Studies have shown that younger women with breast cancer have worse survival than older women, which may be an expression of underlying more aggressive tumor biology. In addition many invasive breast carcinomas in African–American (AA) women belong to the so called "triple negative" subtype that is associated with worse overall prognosis. In this study we evaluated the demographics and tumor characteristics of young women with invasive breast carcinomas to examine the hypothesis that young AA breast cancer patients have more aggressive tumor characteristics than their young white counterparts.
Design: Our population consisted of 140 consecutive patients <40 years of age (mean 34, range 20-39) diagnosed with invasive breast carcinomas from 2003-2009. Electronic medical records were reviewed to determine demographics and pathologic tumor characteristics including lymph node status, histologic grade and type, size, and breast marker profile (ER, PR, HER-2, EGFR and MIB-1).
Results: Six (4%) of 140 patients were 20-24 years old, 18 (13%) were 25-29 years old, 35 (25%) were 30-34 years old and 81 (58%) were 35-39 years old. 76 (54%) were White, 44 (31%) were AA, 11 (8%) were Hispanic, 6 (4%) were Asian and 3 (2%) were of other races. Invasive ductal carcinoma was diagnosed in 120 (86%), lobular in 2 (1%), mixed ductal and lobular in 15 (11%) and 3 (2%) had other tumor types. The average tumor size was 2.3 cm. 84 (60%) of these young patients had grade III tumors and 61 (53%) had positive lymph node status. Only 52% of the patients were ER positive and only 44% were PR positive. 30% were HER-2 positive, 24% were EGFR positive, and 64% had an unfavorable MIB-1 proliferative index. AA patients had a higher number of ER negative (30/44 vs 27/70, p=0.002), grade III tumors (34/44 vs 44/75, p=0.03) than white patients. These tumors tended to be PR negative (29/43 vs 35/70, p=0.06). There was no significant difference in lymph node status, histologic type, average size, HER-2 and EGFR expression.
Conclusions: 1.Young (<40 years old) breast cancer patients have a higher rate of positive lymph node status, and poorly differentiated grade III, ER negative/PR negative tumors than women more than 50 years old (as based on SEER data). 2. Young AA patients have an even higher number of ER negative, grade III tumors than young white patients. The results of this study suggest that the worse biologic characteristics of invasive carcinomas in AA patients are already evident even in the young women cohorts.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 33, Tuesday Morning