Jin You Kim MD, Abstract Co-Author: Nothing to Disclose

Ji Won Lee MD, Abstract Co-Author: Nothing to Disclose

Suk Kim MD, Abstract Co-Author: Nothing to Disclose

Suck Hong Lee, Abstract Co-Author: Nothing to Disclose

Ji Eun Jo, Presenter: Nothing to Disclose

Breast cancer rarely occurs in women under age 35. The purpose of this study was to retrospectively evaluate magnetic resonance imaging (MRI) findings and clinicopathologic characteristics of invasive breast cancer in young women (age < 35) and to compare them with those of breast cancers in less young premenopausal women (35 ≤ age ≤ 45).

A total of 270 invasive breast cancers in 266 premenopausal women 45 years and younger who underwent preoperative breast MRI were identified between February 2009 and February 2013. Subjects were divided into two age groups: young group (< 35 years, n = 56) and less young group (35-45 years, n = 214). MRI features (morphology, kinetics, T2-weighted signal intensity, and visual grading of background parenchymal enhancement), clinicopathologic data (presentation, tumor size, lymph node status, histologic grade, estrogen receptor (ER), progesteron receptor (PR), human epidermal growth factor receptor 2, p53, and Ki-67 expression), and the visibility of cancer on mammogram were compared between two groups.  

On MRI, young group was more likely to have smooth mass margin (65.0% vs 15.5%, P < .001), hyperintense signal on T2-weighted image (39.3% vs 25.2%, P = .037), and less likely to have irregular shape (10.0% vs 40.5%, P < .001) than less young group. No differences were found for kinetics and background parenchymal enhancement. Axillary nodal involvement (60.7% vs 36.4%, P = .001), higher histologic grade (grade1; 7.1% vs 17.8%, grade 2; 39.3% vs 45.8%, grade 3; 53.6% vs 36.4%; P = .032), ER negative (46.4% vs 25.2%, P = .002), PR negative (57.4% vs 26.2%, P < .001), higher expression of p53 and Ki-67 (≥ 20% positive tumor cells; 50.0% vs 22.4% and 64.3% vs 40.2%, P < .001 and P = .001, respectively) were more frequently observed in young group compared to less young group. The visibility of cancers on mammogram for young group (64.3% vs 82.2%, P = .004) was lower than less young group, despite comparable tumor size (mean; 2.7 vs 2.6cm, P = .89).

Invasive breast cancers occurring in women under 35 years of age frequently have morphologic features commonly seen in benign lesion on MRI, and are associated with aggressive histology and unresponsiveness to endocrine therapy.

Breast cancers in young women (<35 years) have unfavorable biologic features, whereas they frequently have morphologic features commonly seen in benign lesion on MRI.

Kim, J, Lee, J, Kim, S, Lee, S, Jo, J, Invasive Breast Cancer in Women 35 Years of Age or Younger: MR Imaging and Clinicopathologic Features.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13012389.html