Škimelytė Monika, Sungailė Paula, Dambrauskas Lukas, Paškevičiūtė Paulina, Šližinskas Mantas
Department of Radiology, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
Department of Surgery, Medical Academy, Faculty of Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania.
Medicina (Kaunas). 2025 Aug 8;61(8):1429. doi: 10.3390/medicina61081429.
: Breast cancer is the most common malignant disease among women. The aim of this study is to compare clinical, histological, and radiological findings of breast cancer between younger and older women. : This retrospective study enrolled 241 patients with histologically diagnosed breast cancer from January 2015 to December 2021. The patients were divided into two groups: the first group comprised young women aged 49 years or younger and the second group consisted of older women aged over 70 years. Because preventive mammograms were only performed on patients between the ages of 50 and 69 until 2025, we did not include this interval in the study; therefore, only younger and older women who had not undergone preventive mammograms were selected. All patients underwent radiological examinations, including mammography, ultrasound, and magnetic resonance imaging. The parameters were compared between the two groups to evaluate clinical, histological, and radiological features. : During the study period, a total of 241 patients were included in the final analysis, with 94 (39%) being younger women and 147 (61%) being older women. Clinical signs were analyzed, revealing that redness and swelling (19%) and pain (17.7%) were statistically significantly more common in the older women group compared to the younger group ( < 0.013 and < 0.002, respectively). The hormone receptor status of patients in both cohorts did not differ significantly, except for human epidermal growth factor receptor 2 (HER2). Older patients had a significantly higher percentage of HER2-negative disease (83.7%) compared to younger patients (70.2%) ( < 0.013). Older women were statistically significantly more likely to have G2 (68.5%) and G3 (21.7%) tumors compared to younger women (G2-36.6% and G3-46.6%) ( < 0.001). Ki67 < 40% (61.2%) was statistically significantly more common in the older women group, while Ki67 ≥ 40% was more prevalent in the younger women group ( < 0.001). Lobular (19.7%) and ductal (62.6%) histological types of cancer were more common in the older women group ( < 0.001). Comparing cancer changes in MRI and ultrasound scans with the results of postoperative histology showed a sensitivity of 87.8% for MRI and 82.7% for ultrasound. Our study suggests that younger women have a higher percentage of proliferation index Ki67 > 40% (73.9%), which is statistically more significant than in the older women group with Ki67 < 40% (63%) ( < 0.001). : All diagnostic tools are essential for early breast cancer detection. Malignant microcalcifications are typically identified through mammography. Breast MRI was found to be more sensitive in detecting breast cancer compared to mammography and ultrasound. While ultrasound is considered the most sensitive and specific diagnostic tool for axillary lymph node evaluation, it is unfortunately not sensitive enough to determine the exact extent of cancer spread. During our retrospective study, T1 and T2 histological sizes were identified most frequently; the earlier the diagnosis is made, the higher the chances of survival and improved quality of life.
乳腺癌是女性中最常见的恶性疾病。本研究的目的是比较年轻女性和老年女性乳腺癌的临床、组织学和放射学表现。:本回顾性研究纳入了2015年1月至2021年12月期间241例经组织学诊断为乳腺癌的患者。患者分为两组:第一组为49岁及以下的年轻女性,第二组为70岁以上的老年女性。由于在2025年之前仅对50至69岁的患者进行预防性乳房X光检查,我们在研究中未纳入此年龄段;因此,仅选择未接受预防性乳房X光检查的年轻女性和老年女性。所有患者均接受了包括乳房X光检查、超声检查和磁共振成像在内的放射学检查。比较两组之间的参数以评估临床、组织学和放射学特征。:在研究期间,共有241例患者纳入最终分析,其中94例(39%)为年轻女性,147例(61%)为老年女性。对临床体征进行分析,结果显示老年女性组中发红和肿胀(19%)以及疼痛(17.7%)在统计学上显著多于年轻女性组(分别为P<0.013和P<0.002)。除人表皮生长因子受体2(HER2)外,两组患者的激素受体状态无显著差异。老年患者HER2阴性疾病的比例(83.7%)显著高于年轻患者(70.2%)(P<0.013)。与年轻女性(G2为36.6%,G3为46.6%)相比,老年女性在统计学上更有可能患有G2(68.5%)和G3(21.7%)级肿瘤(P<0.001)。Ki67<40%(61.2%)在老年女性组中在统计学上更为常见,而Ki67≥40%在年轻女性组中更为普遍(P<0.001)。小叶癌(19.7%)和导管癌(62.6%)组织学类型在老年女性组中更为常见(P<0.001)。将MRI和超声扫描中的癌症变化与术后组织学结果进行比较,结果显示MRI的敏感性为87.8%,超声的敏感性为82.7%。我们的研究表明,年轻女性增殖指数Ki67>40%的比例较高(73.9%),在统计学上比Ki67<40%的老年女性组更显著(63%)(P<0.001)。:所有诊断工具对于早期乳腺癌检测都至关重要。恶性微钙化通常通过乳房X光检查发现。与乳房X光检查和超声检查相比,乳房MRI在检测乳腺癌方面更敏感。虽然超声被认为是评估腋窝淋巴结最敏感和特异的诊断工具,但遗憾的是,它在确定癌症扩散的确切范围方面不够敏感。在我们的回顾性研究中,T1和T2组织学大小最常被确定;诊断越早,生存机会和生活质量改善的可能性就越高。