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Invasive breast cancers in adolescent and young adult women show more aggressive immunohistochemical and clinical features than those in women aged 40–44 years

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Abstract

Background

Limited knowledge exists concerning the clinicopathological features of breast cancers (BCs) occurring in adolescent and young adult (AYA) women. We evaluated tumor characteristics in AYA women in comparison with those in middle-aged premenopausal women.

Methods

From consecutive AYA patients (< 35-year-old) with invasive BC in a single institute, 82 patients first treated with surgery were examined. As the control group, 82 tumors from middle-aged premenopausal patients (40–44 years) were selected by matching pathological T and N factors. We compared habitual factors, immunohistochemical parameters, and patient outcome between the two groups.

Results

Most of the study population (148 of 164, 90.2%) were in the early clinical stages (stage I or II). In the AYA group, the number of childbirths was smaller (p < 0.0001), while the volume of alcohol consumption was larger (p < 0.0001), and palpable primary tumors were more frequent (p < 0.01) than in the control group. The positivities of estrogen receptor, progesterone receptor, and androgen receptor were lower (p < 0.001, p = 0.03, and p < 0.001, respectively), and the triple-negative (TN) BCs rates were higher (p < 0.01) in the AYA group. Distant recurrence-free survival (DRFS) curves were different in the whole population (p = 0.02) and in hormone receptor-positive cases (p = 0.01).

Conclusions

We confirmed that BCs occurring in AYA women had more aggressive features than those of the older premenopausal women in terms of a high proportion of TN subtypes and a lower DRFS.

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Acknowledgements

We thank to Sachiko Miura, M.T., Chizu Kina, M.T., Toshiko Sakaguchi, M. T., Yasuo Shibuki, M. T., and Ms. Chinami Onuma for technical assistance.

Author information

Authors and Affiliations

  1. Department of Pathology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Ai Hironaka-Mitsuhashi, Masayuki Yoshida & Nobuyoshi Hiraoka

  2. Division of Molecular and Cellular Medicine, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Ai Hironaka-Mitsuhashi

  3. Course of Advanced Clinical Research of Cancer, Juntendo Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Ai Hironaka-Mitsuhashi & Toshikazu Ushijima

  4. Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan

    Hitoshi Tsuda

  5. Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Chikako Shimizu, Kenji Tamura & Yasuhiro Fujiwara

  6. National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Chikako Shimizu

  7. Department of Breast Surgery, National Cancer Center Hospital, Tokyo 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Sota Asaga, Takashi Hojo & Takayuki Kinoshita

  8. Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Sota Asaga

  9. Department of Breast Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Takashi Hojo

  10. Division of Epigenomics, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Toshikazu Ushijima

Authors
  1. Ai Hironaka-Mitsuhashi
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  2. Hitoshi Tsuda
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  3. Masayuki Yoshida
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  4. Chikako Shimizu
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  8. Takayuki Kinoshita
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  9. Toshikazu Ushijima
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  11. Yasuhiro Fujiwara
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Corresponding author

Correspondence to Hitoshi Tsuda.

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Conflict of interest

Y. F. reports grants and other from Japan Agency for Medical Research and Development, grants and other from the Ministry of Health Labor and Welfare, Japan, during the conduct of the study; others from Astra Zeneca KK, other from Eisai Co., Ltd, other from Daiichi Sankyo Co., Ltd, other from Taiho Pharmaceutical Co., Ltd, grants from Takeda Pharmaceutical Co., Ltd, grants and other from Chugai Pharmaceutical Co., Ltd, other from Eli Lilly Japan KK, other from Novartis Pharma KK, outside the submitted work. Other authors have stated that they have no conflicts of interest. All authors have approved the final article.

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Hironaka-Mitsuhashi, A., Tsuda, H., Yoshida, M. et al. Invasive breast cancers in adolescent and young adult women show more aggressive immunohistochemical and clinical features than those in women aged 40–44 years. Breast Cancer 26, 386–396 (2019). https://doi.org/10.1007/s12282-018-00937-0

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  • DOI: https://doi.org/10.1007/s12282-018-00937-0

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