[271] Clinicopathologic Characteristics and Molecular Subtypes of Breast Cancers in Young Women

HD Morris, E King, Y Peng, VR Sarode. University of Texas Southwestern Medical Center, Dallas, TX

Background: Breast cancer in young women has been suggested to have distinct biologic characteristics. Gene expression analysis has demonstrated different subtypes of invasive carcinoma with distinct biologic behavior. In this study we analyzed clinico-pathologic characteristics, frequency of different molecular subtypes of invasive carcinoma (based on ER, PR and Her2Neu expression) ploidy, Ki67 and p53 expression in young women.
Design: Women 40 years and younger with a diagnosis of breast carcinoma from 2000 to 2008 were retrieved from the electronic medical record. Clinical and pathologic data such as ethnicity, family history, stage, tumor size, histologic types, and grade were recorded. Tumor markers (ER, PR, Her2Neu, Ki67, ploidy and p53) were performed by immunohistochemistry in a routine fashion and analyzed by automated DAKO ACIS III image analyzer. Positive (3+) and borderline (2+) Her2Neu results were confirmed by FISH.
Results: There were 162 cases with an age range of (21 - 40), mean 34.69. Hispanics comprised 69 (43%); African American, 55 (34%); Caucasian, 32 (20%). Risk factors include: positive family history in 55 (34%), smoking in 37 (29%), use of oral contraceptives in 34 (21%) and age at menarche 12.8, range (9 - 18). There were 34 (21%) stage 1; 57 (35%) stage II; 33 (20%) stage III and 27 (17%) stage IV. Positive lymph nodes were present in 97 (64%). 134 (83%) were invasive ductal carcinoma, 11 (7%) mixed ductal/lobular, 5 (3%) metaplastic, 4 (2%) medullary, 3 (2%) mucinous, 2 (1%) lobular and 7 (4%) in situ. 110 (68%) were grade III; 30 (19%) grade II; 9 (6%) grade I. 108 (72%) were aneuploid and 42 (28%) diploid. Growth fraction (ki67) was > 10% in 130 (87%) and < 10% in 20 (13%). Of the molecular subtypes, ER+PR+Her2- comprised 62 (42%), ER-PR-Her2- 56 (36%), Her2+ in 19 (13%) and ER+PR+Her2+ in 14 (9%). On follow-up, recurrence was noted in 32 (27%), death in 25 (21%) and in 60 (51%) there was no evidence of disease.
Conclusions: Breast cancers in young women of predominantly minority population have poor prognostic features characterized by higher stage at presentation, a predominance of high-grade tumors that were aneuploid with high growth fraction, and unfavorable outcome. In young women the ER+PR+Her2- subtype was the most frequent followed by the triple negative.
Category: Breast

Tuesday, March 23, 2010 9:30 AM

Poster Session III # 32, Tuesday Morning

 

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