Comparison of the immunohistochemical profile between women with breast cancer over 40 and under 40 years old

Authors

DOI:

https://doi.org/10.11606/issn.1679-9836.v103i2e-210544

Keywords:

Breast Carcinoma, Mammary Ductal Carcinoma, Lobular Carcinoma, Mass Screening

Abstract

Objective: To compare immunohistochemical profiles, such as surrogate molecular classifications of breast carcinomas and histological findings, among women under and over 40 years of age. Methods: This was an observational, quantitative, and retrospective study based on data from the Instituto de Patologia de Araçatuba (IPAT), located in the countryside of the state of São Paulo, Brazil. Pathology reports from biopsy or surgical excision recorded between January 1, 2017, and June 30, 2020 (42 months) were reviewed. Only ductal and lobular carcinomas were histologically analyzed. Age, histological subtype, and immunohistochemical data of estrogen receptor, progesterone receptor, Her-2 and Ki-67 (< 20% x ≥ 20%) were analyzed. Specimens were categorized into two groups based on patient age at diagnosis (≤ 40 years vs. > 40 years). Results: There was no significant difference between the two age groups regarding hormone receptor, Her-2 evaluation, or histological classification (ductal vs. lobular). Nevertheless, breast cancer in younger women was associated with a higher Ki-67 index (p = 0.015). In the group aged 40 years and younger, half of the cases were classified as Luminal B-like, Her-2 negative, and 19% were triple-negative. For women over 40 years old, 57% were classified as luminal B-like, Her-2 negative, 9% were luminal A-like, and only 13% were triple-negative. Conclusion: The frequency of breast among young woman is substantial, and they tend to exhibit higher Ki-67 indexes.

Downloads

Download data is not yet available.

References

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin [Internet]. 2021;71(3):209–49. Doi: http://dx.doi.org/10.3322/caac.21660

Instituto Nacional do Câncer (Brasil). Estimativa 2020: Incidência de Câncer no Brasil. Rio de Janeiro: Instituto Nacional do Câncer, 2020. https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf.

WHO Classification of Tumours Editorial Board. Breast tumours. Lyon (France): International Agency for Research on Cancer; 2019. (WHO classification of tumours series, 5th ed.; vol. 2).

Eroles P, Bosch A, Pérez-Fidalgo JA, Lluch A. Molecular biology in breast cancer: intrinsic subtypes and signaling pathways. Cancer Treat Rev [Internet]. 2012;38(6):698-707. Doi: http://dx.doi.org/10.1016/j.ctrv.2011.11.005

Vasconcelos I, Hussainzada A, Berger S, Fietze E, Linke J, Siedentopf F, et al. The St. Gallen surrogate classification for breast cancer subtypes successfully predicts tumor presenting features, nodal involvement, recurrence patterns and disease free survival. Breast [Internet]. 2016;29:181-5. Doi: http://dx.doi.org/10.1016/j.breast.2016.07.016

Deus Moura R, Carvalho FM, Bacchi CE. Breast cancer in very young women: Clinicopathological study of 149 patients ≤25 years old. Breast [Internet]. 2015;24(4):461-7. Doi: http://dx.doi.org/10.1016/j.breast.2015.04.002

Ministério da Saúde. Diretrizes para a Detecção Precoce do Câncer de Mama no Brasil. Rio de Janeiro. Instituto Nacional do Câncer. https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//diretrizes_deteccao_precoce_cancer_mama_brasil.pdf.

Urban LABD, Chala LF, Bauab S di P, Schaefer MB, Dos Santos RP, Maranhão NM de A, et al. Breast cancer screening: updated recommendations of the Brazilian College of Radiology and Diagnostic Imaging, Brazilian Breast Disease Society, and Brazilian Federation of Gynecological and Obstetrical Associations. Radiol Bras [Internet]. 2017;50(4):244-9. Doi: http://dx.doi.org/10.1590/0100-3984.2017-0069

Oeffinger KC, Fontham ETH, Etzioni R, Herzig A, Michaelson JS, Shih Y-CT, et al. Breast cancer screening for women at average risk: 2015 guideline update from the American Cancer Society: 2015 Guideline update from the American cancer society. JAMA [Internet]. 2015;314(15):1599-614. Doi: http://dx.doi.org/10.1001/jama.2015.12783

Perry N, Broeders M, de Wolf C, Törnberg S, Holland R, von Karsa L. European guidelines for quality assurance in breast cancer screening and diagnosis. Fourth edition--summary document. Ann Oncol [Internet]. 2008;19(4):614-22. Doi: http://dx.doi.org/10.1093/annonc/mdm481

Lee EH, Park B, Kim N-S, Seo H-J, Ko KL, Min JW, et al. The Korean guideline for breast cancer screening. J Korean Med Assoc [Internet]. 2015;58(5):408. Doi: http://dx.doi.org/10.5124/jkma.2015.58.5.408

Hamashima C, Japanese Research Group for the Development of Breast Cancer Screening Guidelines, Hamashima C C, Hattori M, Honjo S, Kasahara Y, et al. The Japanese guidelines for breast cancer screening. Jpn J Clin Oncol [Internet]. 2016;46(5):482-92. Doi: http://dx.doi.org/10.1093/jjco/hyw008

Anders CK, Johnson R, Litton J, Phillips M, Bleyer A. Breast cancer before age 40 years. Semin Oncol [Internet]. 2009;36(3):237-49. Doi: http://dx.doi.org/10.1053/j.seminoncol.2009.03.001

Özmen V, Özmen T, Doğru V. Breast cancer in Turkey; An analysis of 20.000 patients with breast cancer. Eur J Breast Health [Internet]. 2019;15(3):141-6. Doi: http://dx.doi.org/10.5152/ejbh.2019.4890

Moraes AB de, Zanini RR, Turchiello MS, Riboldi J, Medeiros LR de. Estudo da sobrevida de pacientes com câncer de mama atendidas no hospital da Universidade Federal de Santa Maria, Rio Grande do Sul, Brasil. Cad Saude Publica [Internet]. 2006;22(10):2219-28. Doi: http://dx.doi.org/10.1590/s0102-311x2006001000028

Schneider IJC, d’Orsi E. Sobrevida em cinco anos e fatores prognósticos em mulheres com câncer de mama em Santa Catarina, Brasil. Cad Saude Publica [Internet]. 2009;25(6):1285-96. Doi: http://dx.doi.org/10.1590/s0102-311x2009000600011

Cortet M, Bertaut A, Molinié F, Bara S, Beltjens F, Coutant C, et al. Trends in molecular subtypes of breast cancer: description of incidence rates between 2007 and 2012 from three French registries. BMC Cancer [Internet]. 2018;18(1). Doi: http://dx.doi.org/10.1186/s12885-018-4080-8

Pandit P, Patil R, Palwe V, Gandhe S, Patil R, Nagarkar R. Prevalence of molecular subtypes of breast cancer: A single institutional experience of 2062 patients. Eur J Breast Health [Internet]. 2020;16(1):39-43. Doi: http://dx.doi.org/10.5152/ejbh.2019.4997

Sharma JD, Khanna S, Ramchandani S, Kakoti LM, Baruah A, Mamidala V. Prevalence of molecular subtypes of breast carcinoma and its comparison between two different age groups: A retrospective study from a tertiary care center of northeast India. South Asian J Cancer [Internet]. 2021;10(4):220-4. Doi: http://dx.doi.org/10.1055/s-0041-1731905

Jain S, Narang V, Jain K, Paul D, Singh J, Sohi AS, et al. Prevalence of molecular subtypes in operated cases of breast cancer and its clinicopathological correlation: A single institute study from a tertiary cancer centre in north India. Indian J Surg Oncol [Internet]. 2021;12(3):538-44. Doi: http://dx.doi.org/10.1007/s13193-021-01374-w

Ushimado K, Kobayashi N, Hikichi M, Tsukamoto T, Kuroda M, Utsumi T. Differences in clinicopathologic features and subtype distribution of invasive breast cancer between women older and younger than 40 years. Fujita Med J [Internet]. 2019;5(4):92-7. Doi: http://dx.doi.org/10.20407/fmj.2019-001

Partridge AH, Hughes ME, Warner ET, Ottesen RA, Wong Y-N, Edge SB, et al. Subtype-dependent relationship between young age at diagnosis and breast cancer survival. J Clin Oncol [Internet]. 2016;34(27):3308-14. Doi: http://dx.doi.org/10.1200/jco.2015.65.8013

Kim NH, Bang HW, Eom YH, Choi SH. The different prognostic impact of age according to individual molecular subtypes in breast cancer. Ann Surg Treat Res [Internet]. 2022;103(3):129-44. Doi: http://dx.doi.org/10.4174/astr.2022.103.3.129

Liedtke C, Rody A, Gluz O, Baumann K, Beyer D, Kohls E-B, et al. The prognostic impact of age in different molecular subtypes of breast cancer. Breast Cancer Res Treat [Internet]. 2015;152(3):667-73. Doi: http://dx.doi.org/10.1007/s10549-015-3491-3

Velentgas P, Daling JR. Risk factors for breast câncer in younger women. J Natl Cancer Inst Monogr [Internet]. 1994;(16):15-24.

Daly AA, Rolph R, Cutress RI, Copson ER. A review of modifiable risk factors in young women for the prevention of breast cancer. Breast Cancer (Dove Med Press) [Internet]. 2021;13:241-57. Doi: http://dx.doi.org/10.2147/BCTT.S268401

Yeo W, Lee H-M, Chan A, Chan EY, Chan MC, Chan K-W, et al. Risk factors and natural history of breast cancer in younger Chinese women. World J Clin Oncol [Internet]. 2014;5(5):1097-106. Doi: http://dx.doi.org/10.5306/wjco.v5.i5.1097

Joslyn SA, Foote ML, Nasseri K, Coughlin SS, Howe HL. Racial and ethnic disparities in breast cancer rates by age: NAACCR Breast Cancer Project. Breast Cancer Res Treat [Internet]. 2005;92(2):97-105. Doi: http://dx.doi.org/10.1007/s10549-005-2112-y

Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies. Lancet [Internet]. 1996;347(9017):1713-27. Doi: http://dx.doi.org/10.1016/s0140-6736(96)90806-5

Mørch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard Ø. Contemporary hormonal contraception and the risk of breast cancer. N Engl J Med [Internet]. 2017;377(23):2228-39. Doi: http://dx.doi.org/10.1056/NEJMoa1700732

Westhoff CL, Pike MC. Hormonal contraception and breast cancer. Am J Obstet Gynecol [Internet]. 2018;219(2):169.e1-169.e4. Doi: http://dx.doi.org/10.1016/j.ajog.2018.03.032

Published

2024-05-24

Issue

Section

Artigos Originais/Originals Articles

How to Cite

Alves, T. M. S. ., Nogueira, R. J. ., Bagio, T. M., Quirino Louzada, M. J., Katsuda, P. G., Camilo-Júnior, D. J. ., & Xavier-Júnior, J. C. C. (2024). Comparison of the immunohistochemical profile between women with breast cancer over 40 and under 40 years old. Revista De Medicina, 103(2), e-210544. https://doi.org/10.11606/issn.1679-9836.v103i2e-210544