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Imaging features of sporadic breast cancer in women under 40 years old: 97 cases

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Abstract

Objectives

To evaluate characteristic features of mammography, ultrasound and magnetic resonance imaging (MRI) of sporadic breast cancer in women <40 years and to determine correlations with pathological and biological factors.

Methods

A retrospective review of radiological, clinicopathological and biological features of sporadic breast cancers for women under 40 years at our institution between 2007-2012 covering 91 patients. Mammography was available for 97 lesions, ultrasound for 94 and MRI for 38.

Results

The most common imaging features were masses, nearly all classified BI-RADS 4 or 5. On mammography microcalcifications alone accounted for 31 %, all suspicious. There were 42.6 % luminal B, 24.5 % luminal A, 19.1 % HER2-enriched and 10.6 % triple-negative (TN) tumours by immunohistochemistry. HER2 overexpression was correlated with the presence of calcifications at mammography (P = 0.03). TN cancers more often had an oval shape and abrupt interface at ultrasound and rim enhancement on MRI. MRI features were suspicious for all cancers and rim enhancement of a mass was a significant predictor of triple-negative tumours (P = 0.01).

Conclusions

The imaging characteristics of cancers in patients under 40 years without proven gene mutations do not differ from their older counterparts, but appear correlated to phenotypic profiles, which have a different distribution in young women compared to the general population.

Key Points

• Young women have more luminal B/HER2+ phenotypes than older women.

• The appearance of cancers is correlated with their biological profiles.

• Sporadic breast cancer imaging in young women is generally classified BI-RADS 4/5.

• Triple-negative cancers can be misinterpreted as benign, requiring thorough imaging analysis.

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Abbreviations

MRI:

magnetic resonance imaging

IDC:

invasive ductal carcinomas

DCIS:

ductal carcinoma in situ

ILC:

infiltrating lobular carcinoma

ER:

oestrogen receptors

PR:

progesterone receptors

FISH:

fluorescent in situ hybridisation

HER2:

human epidermal growth factor receptor 2

TN:

triple negative

ACR:

American College of Radiology

BI-RADS:

Breast Imaging-Reporting and Data System

PACS:

Agfa® picture archiving and communication system

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Acknowledgements

The authors thank Pippa McKelvie-Sebileau of Institut Bergonié for medical editorial assistance in English.

Conflicts of interest: The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Radiology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France

    Bénédicte Bullier, Gabrielle Hurtevent-Labrot & Martine Boisserie-Lacroix

  2. Department of Biopathology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France

    Gaétan MacGrogan

  3. Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Centre, F-33000, Bordeaux, France

    Hervé Bonnefoi

  4. Univ. Bordeaux, F-33000, Bordeaux, France

    Hervé Bonnefoi

  5. INSERM U916, F-33000, Bordeaux, France

    Hervé Bonnefoi

  6. Clinical and Epidemiological Research Unit, Institut Bergonié, F-33000, Bordeaux, France

    Edouard Lhomme & Véronique Brouste

  7. Institut Bergonié, 229 cours de l’Argonne, Bordeaux, 33076, France

    Martine Boisserie-Lacroix

Authors
  1. Bénédicte Bullier
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  2. Gaétan MacGrogan
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Correspondence to Martine Boisserie-Lacroix.

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Bullier, B., MacGrogan, G., Bonnefoi, H. et al. Imaging features of sporadic breast cancer in women under 40 years old: 97 cases. Eur Radiol 23, 3237–3245 (2013). https://doi.org/10.1007/s00330-013-2966-z

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  • DOI: https://doi.org/10.1007/s00330-013-2966-z

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