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

Öz

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.

Anahtar Kelimeler

• 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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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