[Is mammography useful in the detection of breast cancer in women 35 years of age or younger?].

Breast cancer in women 35 years old or younger is unusual. It accounts for 1-3.6% of all breast cancers but is the leading cause of cancer mortality in women 15-35 years old. The diagnostic delay, with T2 or more advanced cancer at clinical presentation, is due to the patient's age and the opinion of low mammographic reliability for cancer diagnosis in this age group. To assess the usefulness of mammography in breast cancer patients aged 35 years or younger, we reviewed the clinical, mammographic and histologic data of 65 cancers collected in 7 breast diagnosis and counseling centers in Lombardy. Fifty-three patients (81.5%) were referred for a palpable breast mass, which was a T2 or more advanced cancer in 23 cases. Mammography showed malignant patterns (spiculated opacities, clusters of microcalcifications, casting, branching and ductal type calcifications) in 31 patients (47.7%). Mammography was not definitive but correctly suggested further examinations in 30 women and it had only 4 false negatives. Ultrasonography performed in 43 patients was negative in 3 (7%), pathologic and pathognomonic for cancer in 27 (62.8%) and pathologic but not indicative of malignancy in 13 (20.2%). The cytologic or histologic diagnosis of breast cancer was made under US guidance in 24 cases. In women aged 35 years or younger mammography was effective in identifying breast cancers; US and fine-needle aspiration biopsy (FNAB) complete mammography. We believe that mammography can be a valuable screening tool in young women at high risk for breast cancer because of family history.