[Immunophenotype and evolution of breast carcinomas: a comparison between very young and postmenopausal women].
OBJECTIVE
The objective of this study was to evaluate the clinical, pathological and molecular characteristics in very young women and postmenopausal women with breast cancer.


METHODS
We selected 106 cases of breast cancer of very young women (<35 years) and 130 cases of postmenopausal women. We evaluated clinical characteristics of patients (age at diagnosis, ethnic group, family history of breast cancer, staging, presence of distant metastases, overall and disease-free survival), pathological characteristics of tumors (tumor size, histological type and grade, axillary lymph nodes status) and expression of molecular markers (hormone receptors, HER2, p53, p63, cytokeratins 5 and 14, and EGFR), using immunohistochemistry and tissue microarray.


RESULTS
When comparing clinicopathologic variables between the age groups, younger women demonstrated greater frequency of nulliparity (p=0.03), larger tumors (p<0.000), higher stage disease (p=0.01), lymph node positivity (p=0.001), and higher grade tumors (p=0.004). Most of the young patients received chemotherapy (90.8%) and radiotherapy (85.2%) and less tamoxifen therapy (31.5%) comparing with postmenopausal women. Lower estrogen receptor positivity 49.1% (p=0.01) and higher HER2 overexpression 28.7% (p=0.03) were observed in young women. In 32 young patients (29.6%) and in 20% of the posmenopausal women, the breast carcinomas were of the triple-negative phenotype (p=0.034). In 16 young women (50%) and in 10 postmenopausal women (7.7%), the tumors expressed positivity for cytokeratin 5 and/or 14, basal phenotype (p=0.064). Systemic metastases were detected in 55.3% of the young women and in 39.2% of the postmenopausal women. Breast cancer overall survival and disease-free survival in five years were, respectively, 63 and 39% for young women and 75 and 67% for postmenopausal women.


CONCLUSIONS
Breast cancer arising in very young women showed negative clinicobiological characteristics and more aggressive tumors.
Dutra
Mara Costa
MC
Programa de Pós-graduação em Patologia Mamária, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Rezende
Marina Alvarenga
MA
de Andrade
Victor Piana
VP
Soares
Fernando Augusto
FA
Ribeiro
Márcio Ventura
MV
de Paula
Elbio Cândido
EC
Gobbi
Helenice
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000276:immunology*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008875:Middle Aged; D017698:Postmenopause; D055815:Young Adult