Bakkali H, Marchal C, Lesur-Schwander A, Verhaeghe J-L
Groupe sein, centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511, Vandoeuvre-lès-Nancy, France.
Cancer Radiother. 2003 Jun;7(3):153-9. doi: 10.1016/s1278-3218(03)00021-0.
Breast cancer rarely occurs in very young women, its diagnosis and management could sometimes be difficult. Our aim is to analyse the epidemiological and clinicopathological features of a group of very young women and especially to evaluate the results of therapeutic strategy.
We report a retrospective study conducted at the department of radiotherapy in Alexis-Vautrin Centre, concerning 30 patients aged < or = 30 years in whom a diagnosis of invasive breast carcinoma was made between 1986 and 2001.
Six patients had familial history of breast cancer. Palpable tumor was found in 90% of cases, the average size was 3.5 cm. Eleven patients presented with stage I, 11 presented with stage II, 6 presented with stage III and 2 presented with stage IV. Five cancers were diagnosed after pregnancy (average tumor size = 5.8 cm). Eleven patients received neoadjuvant chemotherapy and 23 (82%) of 28 operable cases of invasive malignancy underwent breast conservative surgery (BCS). We found an invasive ductal carcinoma with grade III in 13/27 cases and a nodal involvement in a half of cases, 11 patients of 26 had no expression of oestrogen receptor. The average follow-up was 5 years: six patients (20%) recurred locally (all of them were initially treated by BCS), four patients developed a contralateral breast cancer and three developed a second malignancy. Ten patients died of their metastatic disease. The 5-year overall survival rate was 78%.
Our results are consistent with those of the published reports and suggest that very young women with breast cancer have a poorer prognosis compared with the older ones. They should receive, according to their prognostic factors, an appropriate regional, systemic and hormonal therapy.
乳腺癌在非常年轻的女性中很少见，其诊断和治疗有时可能会很困难。我们的目的是分析一组非常年轻女性的流行病学和临床病理特征，尤其是评估治疗策略的结果。
我们报告了在亚历克西斯 - 沃特兰中心放疗科进行的一项回顾性研究，涉及1986年至2001年间诊断为浸润性乳腺癌的30名年龄≤30岁的患者。
6名患者有乳腺癌家族史。90%的病例可触及肿瘤，平均大小为3.5厘米。11名患者为I期，11名患者为II期，6名患者为III期，2名患者为IV期。5例癌症在妊娠后被诊断出（平均肿瘤大小 = 5.8厘米）。11名患者接受了新辅助化疗，28例可手术的浸润性恶性肿瘤病例中有23例（82%）接受了保乳手术（BCS）。我们发现27例中有13例为III级浸润性导管癌，一半病例有淋巴结受累，26名患者中有11名雌激素受体无表达。平均随访时间为5年：6名患者（20%）局部复发（所有这些患者最初均接受BCS治疗），4名患者发生对侧乳腺癌，3名患者发生第二种恶性肿瘤。10名患者死于转移性疾病。5年总生存率为78%。
我们的结果与已发表报告的结果一致，表明非常年轻的乳腺癌女性与年龄较大者相比预后较差。应根据其预后因素给予她们适当的局部、全身和激素治疗。
