COMPARISON OF THE EFFECTS OF CLINICOPATHOLOGICAL AND RADIOLOGICAL FINDINGS ON SURVIVAL IN WOMEN YOUNGER THAN 40 YEARS AND OLDER THAN 55 YEARS OF AGE WITH BREAST CANCER

Year 2023, Volume: 30 Issue: 1, 37 - 45, 14.03.2023

Buket Altun Özdemir , Servet Kocaöz , Bülent Çomçalı , Mustafa Ömer Yazıcıoğlu , Fırat Canlıkarakaya , Cengiz Ceylan , Birol Korukluoğlu

https://doi.org/10.17343/sdutfd.1182177

Abstract

Objective
Tumors of women with breast cancer show clinical
and biological differences depending on the hormonal
changes that develop with age. Therefore, in this study,
we compared the radiologic, and clinicopathological
features of breast cancer patient’s < 40 age and ≥55
age.
Material and Method
The files of a total of 759 patients, including 92
patients under 40 aged, and 322 patients 55 aged and
over who were operated on for breast cancer over a
10-year period in three centres were retrospectively
reviewed and Estrojen Reseptor (ER), Progesteron
Reseptor (PR), Human epidermal growth factor
receptor 2 (HER2), Lymphovascular invasion (LVI)
status, presence of axillary lymph node metastasis
(ALNM), multifocality, presence of Ductal Carsinoma
İnsitu (DCIS) or Lobular Carsinoma İnsitu (LCIS),
tumor size, tumor histopathological type, grade, and
score were recorded.
Results
In patients under the age of 40, the tumor is less
localized in the upper-inner and lower-inner quadrants
of the breast, multifocality is more common, most of
them have dense breast structure, the histological
grade of the tumor is higher, LVI and LNM are more
common. It was found that they had ER receptor
positivity and higher Ki-67 proliferation index (p<0.001,
p<0.001, p<0.001, p<0.001, p=0.021, p=0.039,
p=0.001 and p<0.001, respectively). It was observed
that the multifocality and density of breast tissue were
lower in tumors in patients under 55 years of age (p =
0.002, p <0.001, respectively). Luminal B and TN were
more common among molecular subtypes in patients
under 40 years of age, while luminal A subtype
was more common in patients over 55 years of age
(p<0.001, p=0.001, respectively).
Conclusion
Clinicopathological differences between <40 aged,
and 55 aged and over patients were confirmed.
Adverse prognostic factors for breast cancer at the
age of under 40 patients were revealed.

Keywords

Breast Cancer, lymphovascular invasion, lymph node metastasis, molecular subtype, breast density

40 YAŞ ALTI VE 55 YAŞ ÜSTÜ MEME KANSERLİ KADINLARIN KLİNİKOPATOLOJİK VE RADYOLOJİK BULGULARININ SAĞ KALIM ÜZERİNE ETKİLERİNİN KARŞILAŞTIRILMASI

Abstract

Amaç
Meme kanserli kadınların tümörleri, yaşla birlikte gelişen
hormonal değişikliklere bağlı olarak klinik ve
biyolojik farklılıklar göstermektedir. Bu nedenle bu
çalışmada meme kanserli hastaların <40 yaş ve ≥55
yaşlarının radyolojik ve klinikopatolojik özelliklerini
karşılaştırdık.
Gereç ve Yöntem
10 yıllık dönemde üç merkezde meme kanseri nedeniyle
opere edilen 40 yaş altı 92 hasta ve 55 yaş
ve üzeri 322 hasta olmak üzere toplam 759 hastanın
dosyaları geriye dönük olarak incelendi ve Östrojen
Reseptör (ER), Progesteron Reseptör (PR), İnsan
Epidermal Büyüme Faktörü 2 (HER2) ,Lenfovaskuler
İnvazyon ( LVI ) durumu, Aksiller Lenf Nodu Metastazı
(ALNM) varlığı, multifokalite, Duktal Karsinoma
İnsitu (DCIS) veya Lobuler Karsinoma İnsitu (LCIS)
varlığı, tümör boyutu, tümör histopatolojik tipi, tümör
derecesi ve skoru kaydedildi.
Bulgular
40 yaşın altındaki hastalarda tümörün memenin üst-iç
ve alt-iç kadranlarında daha az yerleştiği, multifokalitenin
ise daha sık görüldüğü, büyük bir çoğunluğunun
dens meme yapısına sahip olduğu, tümörün histolojik
derecesinin yüksek olduğu, LVI ve LNM’nin daha
sık görüldüğü, daha düşük ER reseptör pozitifliği ve
daha yüksek Ki-67 proliferasyon indeksine sahip olduğu
saptandı (sırasıyla p<0.001, p<0.001, p<0.001,
p<0.001, p=0.021, p=0.039, p=0.001 ve p<0.001).
55 yaşının altındaki hastalarda tümörlerde multifokalitenin
ve meme dokusunun yoğunluğunun daha az
olduğu görüldü (sırasıyla p=0.002, p<0.001). 40 yaş
altı hastalarda moleküler alt tiplerden luminal B ve
TN daha fazla görülürken 55 yaş üzeri hastalarda luminal
A alt tipi daha fazla görüldü (sırasıyla p<0.001,
p=0.001).
Sonuç
<40 yaş ile 55 yaş ve üzeri hastalar arasında klinikopatolojik
farklılıklar doğrulandı. 40 yaşın altındaki
hastalarda meme kanseri için olumsuz prognostik
faktörler ortaya çıktı.

Keywords

Meme Kanseri, Lenfovaskuler invazyon, Lenf nodu metastazı, Moleküler alt tip, Meme yoğunluğu

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