Breast cancer in women younger than 30 years: prevalence rate and imaging findings in a symptomatic population

Comparative analysis of breast cancer characteristics in young premenopausal and postmenopausal women in Ghana

Breast cancer is increasingly common among young women in Ghana. BCa is heterogeneous with unique traits that impact causes, prognostic, and predictive outcomes of patients before and after menopause. However, limited evidence exists on differences between young premenopausal (YPM) and postmenopausal cases in Ghana. This study compared breast tumour characteristics between YPM women (under 35 years) and postmenopausal women. We conducted a prospective cross-sectional study involving 140 BCa-diagnosed women at the Breast Care Clinic of Komfo Anokye Teaching Hospital (KATH), Kumasi from November 2019 to June 2021. Thirty-one (22.1%) of participants were YPM and 109 (77.9%) were postmenopausal. The median ages for YPM and postmenopausal were 32.0 (range: 25.0-35.0) and 57.0 (48.0-86.0) respectively. Invasive carcinoma was the most common histological type (97.1%). Left tumour location was the most frequent in both groups (51.6% for YPM and 51.8% for postmenopausal). Lumps detected were frequently in the outer upper quadrant in both groups (61.3% and 56.0%). The majority of the YPM women (80.7%) and postmenopausal women (87.0%) had stage III and IV diseases. Most YPM (64.5%) and postmenopausal women (64.4%) exhibited triple-negative breast cancer (TNBC). Both YPM 13 (56.6%) and postmenopausal participants 40 (56.3%) exhibited a predominantly partial response to neo-adjuvant chemotherapy but YPM women (21.7%) experienced disease progression than the postmenopausal women (12.7%). The study highlights consistent tumour characteristics and advanced clinical stages at diagnosis in both groups with a higher prevalence of TNBC. TNBC and HER2+ subtypes respond better to Anthracycline-based neoadjuvant chemotherapy. Establishing Breast Care Clinics in district and regional hospitals for early detection is crucial and further studies are warranted to understand the higher TNBC prevalence in black Africans and re-evaluate breast education programs to address the persistently late presentations.

Pentagamavunone-1 inhibits aggressive breast cancer cell proliferation through mitotic catastrophe and ROS-mediated activities: in vitro and in vivo studies

Pentagamavunone-1 (PGV-1), an analog of curcumin, has been studied for its cytotoxic effects in 4T1, MCF7, MCF7/HER2, and T47D breast cancer cells. Its antiproliferative effect is partly mediated through G2/M arrest; however, its molecular mechanism during cell cycle progression remains unknown. In this study, we aimed to determine whether PGV-1 has any anticancer effects on highly aggressive breast cancer cells, with a focus on cell cycle regulatory activity, reactive oxygen species (ROS) generation, and their mediated effects on cancer cells. MDA-MB-231 (triple-negative) and HCC1954 (overexpressed HER2) immortalized human breast cancer cells were used in the study. PGV-1 exhibited cytotoxic activity with an irreversible antiproliferative impact on treated cells and had good selectivity when tested in fibroblast cells. Oral PGV-1 administration suppressed tumor growth in a cell-derived xenograft mouse model. PGV-1 induced the phosphorylation of Aurora A kinase and PLK1 in MDA-MB-231 cells, while PLK1 and cyclin B1 phosphorylation were enhanced in the PGV-1-treated HCC1954 cells during prometaphase arrest. Intracellular ROS production was substantially higher upon PGV-1 treatment following mitotic arrest, and this activity caused impairment of mitochondrial respiration, induced senescence, and subsequently triggered early-to-late apoptosis. Collectively, these results suggest that the molecular mechanism of PGV-1 involves the regulation of mitotic kinases to cause cell cycle arrest and the enhancement of ROS production to impair mitochondrial activity and induce cellular senescence. The therapeutic activities demonstrated by PGV-1 in this study show its potential as an appealing candidate for chemotherapy in breast cancer treatment.

Breast cancer in very young women-a multicenter 10-year experience

BACKGROUND

Breast cancer (BC) is the most prevalent cancer in adult young women in Europe. Although rare, it is one of the leading causes of death in this age group. The aim of this study is to characterize a cohort of young women regarding tumor stage, biology, treatment and survival.

PATIENTS AND METHODS

We present a multicenter retrospective analysis of women <35 years of age, diagnosed with BC between 2008 and 2017. A total of 207 patients from five Portuguese centers were included, from whom 172 were eligible for analysis. Data were analyzed using IBM SPPSS statistics.

RESULTS

Median age at diagnosis was 31 years. Fifty-one percent of tumors were hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative, 20% HR-positive/HER2-positive, 8% HR-negative/HER2-positive and 20% triple-negative BC. Twenty-two percent of patients were diagnosed in stage I, 26% stage II, 45% stage III and 6% had de novo metastatic cancer. Thirty-nine percent of patients were treated with neoadjuvant chemotherapy. Mean follow-up time was 64.9 months and overall survival at 5 years, of the entire cohort and metastatic patients, was 86.5% and 26%, respectively.

CONCLUSIONS

In our study we found similar population characteristics to other cohorts <35 years of age. To our knowledge, this is one of the largest cohorts in very young women. BC in young women is an important issue and further studies are needed to provide better care and survivorship to patients.

Defining radiologic complete response using a correlation of presurgical ultrasound and mammographic localization findings with pathological complete response following neoadjuvant chemotherapy in breast cancer

PURPOSE

Breast cancer affects a significant number of patients younger than 40 years in the Gulf and breast conservative treatment is highly preferred. Pathological complete response (pCR) following neoadjuvant chemotherapy is increasingly being observed with the new chemotherapy agents. Although MRI is more accurate in such evaluations, digital mammography and high-resolution ultrasound (US) which are less expensive may accurately predict pCR which is the focus of this study.

METHODS

A 6-year retrospective study of 93 breast cancer cases who had neoadjuvant chemotherapy and had presurgical radiological localization was carried out. Forty-five had US localization while 48 underwent mammographic localization when US failed to define any residual mass. Radiologic complete response (rCR) was defined as absence of mass with only postbiopsy clip overlying normal breast parenchyma pattern in US and in mammography (clip sign). Mass or abnormal parenchymal pattern was considered as residual tumor. The pathology reports of pCR or not with background changes were recorded.

RESULTS

Ultrasound localization correctly predicted 42 out of 43 pathologic masses with 98 % accuracy. Mammographic localization correctly predicted 40 out of 43 pCR with 93 % accuracy. The best responders were triple negative and HER2 positive hormone negative breast cancer.

CONCLUSION

The study defines radiologic complete response (rCR) as absence of a mass with the postbiopsy tissue marker overlying a normal-looking breast parenchyma in both ultrasound and mammographic evaluation. A correlation of 93 % was found with pCR. The few false negative cases were associated with overlying dense breast and possibly post treatment reaction. Allocation of a BI-RADS category for rCR is suggested.

Defining clinicopathological and radiological features of breast cancer in women under the age of 35: an epidemiological study

INTRODUCTION

Breast cancer is the most commonly diagnosed female cancer. Diagnosis in younger women (under 35 years) is different to their older counterparts, and mammography is not considered as sensitive in this cohort. Consequentially, younger patients may present later with more advanced disease.

METHODS

This is a retrospective analysis of a prospectively updated database containing consecutive patients who presented to the symptomatic breast unit of Galway University Hospital between 2009 and 2015. Patient clinicopathologic factors, clinical examination features, diagnostic radiological modalities and Bi-RADS score were all assessed. Data was analysed using Statistical Package for the Social Sciences version 25.

RESULTS

One thousand eight hundred thirty-six patients were diagnosed with breast cancer, and of these, 51 (2.8%) patients were < 35 years. Invasive ductal carcinoma made up 90% of diagnosis, and 42% had an associated ductal carcinoma in situ. Fifty-four percent were high-grade tumours and 52% presented with stage III disease or greater. The main radiological tool used was ultrasound, which had a sensitivity of 87.50% (95% confidence interval [CI] 74.75 to 95.27%). Mammogram sensitivity was 86.84% (95% CI 71.91 to 95.59%). Magnetic resonance imaging was used in 29% of cases, with a sensitivity of 100.00% (95% CI 78.20 to 100.00%).

CONCLUSION

Females under 35 tend to be diagnosed with aggressive, advanced stage tumours. Ultrasound remains the radiological test of choice, although diagnosis using mammography demonstrated a relatively high sensitivity compared with previous reports. This study emphasises the varying epidemiology of breast cancer in younger patients and the potential role of mammography in making radiological diagnosis in those who are symptomatic.

Male Partners' Knowledge, Attitudes, and Perception of Women's Breast Cancer in Abha, Southwestern Saudi Arabia

Background: Breast cancer (BC) is ranked as the most frequently diagnosed cancer site among women in Saudi Arabia. Several studies in Saudi Arabia have reported low awareness of BC and significant obstacles to early presentation among Saudi women. A key sociocultural obstacle against breast screening and early detection of BC in several conservative cultures is that men manage women’s choices and activities. The aim of this research is to find out the key background knowledge, attitudes, and related practice among male partners in the city of Abha in relation to women’s BC prevention and means for early detection. Methods: A cross-sectional study targeting husbands aged 20 years or older chosen from the outpatient clinics in the Urban Primary Health Care Centers in Abha City. Through questionnaires, interview data were collected regarding knowledge about BC and wife practices and attitudes towards BC. Results: The study included 832 husbands. The study showed that only 20.2% (95% confidence interval (CI): 19.9–24.1) of husbands had heard about mammography and only 22.1% had heard about breast self-examination among women as a screening test for BC. The most commonly mentioned variations that might occur in relation to BC were size changes (45.6%). The leading source of BC knowledge was from television (48.9%), and the least-mentioned source of information was healthcare workers (22.4%). Husbands mentioned that only 9.3% of wives had been examined before by mammography. In a multivariate logistic regression of male factors associated with wives’ practices and attitudes towards BC, only good knowledge among husbands was a significant factor. Conclusions: The study documented the low level of BC knowledge among male partners. There is an urgent need to pay more consideration to disseminating awareness among men, as they are associates, and they must be armed with proper awareness. There is an urgent demand for establishing a national program and educational campaigns towards BC. Stressing the advantages and access to free mammography is necessary.