The features of breast cancer in young women and the diagnostic efficacy of imaging means
LIU Dan-qing1, ZHANG Wei1, WANG Hui-ying1, HAN Lu2, LV Dong-jun1
(1.Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China;
2.Department of Radiology, Liaoning Cancer Hospital, Shenyang 110042, China)
Abstract：Objective: This is a retrospective study which analyzed the clinical, pathological and radiological information of young women with pathological confirmed breast cancer(≤35 years) in the past four years in our hospital to evaluate the diagnostic value of various imaging methods. Methods: Retrospective analyzed 174 patients(under 35 years old) with 180 pathological confirmed breast cancer lesions in our hospital from January 2011 to December 2014(the average age was 31.6). All patients underwent ultrasound, and 89/174 patients underwent pre-operation mammography, and 21/174 underwent dynamic contrast-enhanced MRI. The status of first clinical symptoms, pathological type, immunohistochemically result, lymph node metastasis, breast imaging performance characteristics, the classification of Breast Imaging Reporting Data System were analyzed. Results: The majority clinical symptom of breast cancer in young women is breast masses which were found occasionally or by health examination(94/174, 54.0%). The main histological type is invasive ductal carcinoma(148/180, 82.2%), and Ⅱ/Ⅲ grade carcinoma accounted for majority of invasive ductal carcinoma(118/148, 79.7% and 20/148, 13.5%). Axillary lymph node-positive rate is high(55/140, 39.3%). Immunohistochemical results showed that the expression level of hormone receptor is low, 36.2% of breast cancer expressed estrogen receptor negative(63/174), 33.3% of breast cancer expressed progesterone receptor negative(58/174); 58.6% of breast cancers was Luminal A type(82/140). Mammography findings maily performed as mass (or with calcification)(52/78, 66.7%), with high density, irregular, blurred edges. The sensitivity and specificity of the breast ultrasound are 100% and 97.1%, respectively and of mammography are 96.6% and 87.6%, respectively, and of dynamic contrast-enhanced breast MRI are both 100%. Conclusions: Breast cancer in young women usually showed breast masses with no symptoms as the main clinical manifestation. The main pathologic type is high-level(Ⅱ, Ⅲ grade) invasive ductal carcinoma, with high lymph node metastasis rate, high ER, PR negative rate, and majority immunohistochemistry type of breast cancer is Luminal A type. The main characteristics of breast cancer mammography images are irregular shape, blurred edge and high density mass(with calcification). The sensitivity and specificity of breast ultrasound is relatively high, which should be taken as the main screening tool for breast cancer in young women. When faced with suspected malignant lesions, joint applying two or more imaging approaches could improve the specificity of diagnosis and avoid unnecessary biopsies and surgery.
刘丹青1，张 伟1，王慧颖1，韩 露2，吕冬君1. 青年女性乳腺癌特征及影像检查手段效能评价[J]. 中国临床医学影像杂志, 2017, 28(5): 331-336.
LIU Dan-qing1, ZHANG Wei1, WANG Hui-ying1, HAN Lu2, LV Dong-jun1. The features of breast cancer in young women and the diagnostic efficacy of imaging means. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(5): 331-336.
[1]Weber-Mangal S, Sinn HP, Popp S, et al． Breast cancer in young women(<or=35 years): Genomic aberrations detected by comparative genomic hybridization[J]． Inl J Cancer, 2003, 107(4): 583-592.
[2]Hart W, Kim SW, Park IA, et al． Young age: an independent risk factor for disease-free survival in women with operable breast cancer[J]． BMC Cancer, 2004, 4: 82.
[3]孟洁，郎荣刚，范宇，等. 年轻乳腺癌患者的病理学和生物学特征及其与预后的关系[J]． 中华肿瘤杂志，2007，29（4）：284-288.
[4]杨桦，王思愚，区伟，等． 华南地区年轻乳腺癌患者的临床特征及预后因素分析[J]． 癌症，2009，28（12）：1310-1316.
[5]张文婧，宋冰，谷川，等． 青年期女性乳腺癌的临床及病理特点[J]． 南方医科大学学报，2010，30（6）：1458-1462.
[6]Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age[J]. Cancer, 1996, 78(8): 1838-1843.
[7]Han W, Kang SY． Relationship between age at diagnosis and outcome of premenopausal breast cancer: age less than 35 years is a reasonable cut-of for defining young age-onset breast cancer[J]． Breast Cancer Res Treat, 2010, 119(1): 193-200．
[8]Kataoka A, Tokunaga E, Masuda N, et al. Clinicopathological features of young patients(<35 years of age) with breast cancer in a Japanese Breast Cancer Society supported study[J]. Breast Cancer, 2014, 21(6): 643-650.
[9]Di Nubila B, Cassano E, Urban LA, et al． Radiological features and pathological-biological correlations in 348 women with breast cancer under 35 years old[J]. Breast, 2006, 15(6): 744-753.
[10]Bullier B, MacGrogan G, Bonnefoi H, et al． Imaging features of sporadic breast cancer in women under 40 years old: 97 cases[J]. Eur Radiol, 2013, 23(12): 3237-3245.
[11]Kim JY, Lee SH, Lee JW, et al. Magnetic resonance imaging characteristics of invasive breast cancer in women aged less than 35 years[J]. Acta Radiol, 2015, 56(8): 924-932.
[12]Yiun TS, Esther C, Suvarna L, et al. Young breast cancer in a specialised breast unit in singapore: clinical, radiological and pathological factors[J]. Ann Acad Med Singapore, 2014, 43(2): 79-85.
[13]Keegan TH, DeRouen MC, Press DJ, et al. Occurrence of breast cancer subtypes in adolescent and young adult women[J]. Breast Cancer Res, 2012, 14(2): R55.
[14]Lin CH, Liau JYu, Lu YS, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia[J]. Cancer Epidemiol Biomarkers Prev, 2009, 18(6): 1807-1814.
2017, Vol. 28 
