Breast Cancer in Young Women Aged 35 or Less

754 Background: Breast cancer (BC) in young women is often associated with aggressive tumor features and poor prognosis. The incidence of disease seems to increase. Therefore, a retrospective review was undertaken for pathological and biologic factors and the outcome was analyzed. Methods: 47 patients (pts) aged 35 and younger were treated for BC between 1994 and 2003. Mean age was 31,6. 24 pts received neoadjuvant, 22 pts adjuvant chemotherapy (CH). The adjuvant treatment was individual tailored. 6 pts received CMF. 23 pts were treated with anthracycline-based, 7 with taxane-based CH, 4 with a combination of both. 45 pts underwent radiation after CH. Tissue from tumorectomy was analyzed for ER, PgR, p53, Ki67, Her2-neu, EGRF, UPA and PAI1. Results: In 79% the initial tumor was more than 2cm. All pts with T3 and T4 tumors were treated with neoadjuvant CH. Nearly half of the pts (49%) presented with lymph node metastases. 81% of all tumors were invasive ductal. 60% were classified as grade 3. 67% of all tumors were ER+ and 53% PgR+. P53 was mutated in 42%(n=31), Her2neu positive in 55%(n=40), a high Ki67(>18%)(n=31)was found in 68%. EGRF status was negative in 80%(n=20), UPA was positive in 81%(n=21), PAI1 positive in 91%(n=21). 37 pts (79%) received breast conserving therapy (BCT), 6 combined with oncoplastic surgery. 6 pts (16%) with BCT suffered a local relapse, 1(10%) relapse seen with mastectomy. In 70% of pts without local relapse and BCT the tumor was 20mm or less. 65% of all pts have no metastases, 81,4% are still with no evidence of tumor, 83% are still alive. The mean follow-up is 44 months. Conclusions: More than 80% of the pts are still alive despite the aggressiveness and poor reputation of tumors in younger women. A higher rate of local relapses in pts with BCT could be seen, but smaller tumors seem to have a lower risk of recurrence. However, individual treatment adapted to each pt is necessary and important. No significant financial relationships to disclose.