Analysis Of Clinicopathological Features Of 56 Patients With Breast Cancer Younger Than 35 Years Old

Objective:1.To explore the differences in the compositional ratio of family history of direct tumors in young and middle-aged breast cancer patients.2.Analyze the impact of delayed diagnosis on the staging of young breast cancer.3.The clinicopathological features and molecular biological characteristics of breast cancer patients in the young and middle-aged groups were compared.Methods: The analysis of clinical data of 670 patients with breast cancer who underwent breast surgery in Hebei General Hospital from January 2014 to December 2018.Among them,56 cases were in the young group(<35 years old)and 614 cases were in the middle-aged group(>35 years old).The clinical characteristics,pathological features and molecular typing of the two groups were analyzed.Results:1.Family history of direct tumorsThe patients with a family history in two groups were 9(16.1%)cases and 49(8.0%)cases,respectively.The proportion of young patients with a family history of direct tumors was significantly higher than middle-aged and elderly patients(χ2=0.048,P=0.043).2.Diagnostic delayThe median diagnosis time of breast cancer patients in the two groups were 60 days and 30 days.The median diagnostic delay time in the young group was prolonged.There was no significant difference(P=0.942).The diagnosis delayed time was limited to 3 months,and there was no statistical difference(χ2=0.254,P=0.614).The analysis showed that the delayed diagnosis > 3 months in the young group was significantly positively correlated with advanced(stage III)tumor(P=0.000),and was not related to the family history and occupation(P>0.05).3.Pathological features and molecular typingThere was no significant difference in the pathological types of the two groups(χ2=2.538,P=0.468).Histologic Grade(G)3 in the two groups were 16(31.4%)cases and 101(18.1%)cases,respectively.The proportion of G3 patients in the young group was significantly increased(χ2=5.303,P=0.021).The vascular invasion in the two groups were 19(37.3%)cases and 103(18.5%)cases,respectively.In the young group,the rate of vascular invasion was significantly higher than the middle-aged group(χ2=10.139,P=0.001).The advanced stage(stage III)of pTNM were 21(37.5%)cases and 133(21.7%)cases in the two groups,respectively.the proportion of advanced patients in young group increased significantly(χ2=7.273,P=0.007).Further analysis found that the two groups of patients with T1 were 17(30.4%)and 305(49.7%),respectively.The proportion of patients with T1 in the young group was significantly lower(χ2=7.672,P=0.006);the patients in the T3 stage were 9(16.1%)and 17(2.8%),respectively.The proportion of patients with T3 in the young group was significantly higher(χ2=20.912,P=0.000).The two groups of regional lymph node positive patients were 32(57.1%)cases and 254(41.4%)cases,respectively.The proportion of lymph node positive in young group was significantly increased(χ2=5.220,P=0.022);The proportion of lymph node metastasis in N1,N2,and N3 in the young group was higher than that in the middle-aged and elderly group,but only the proportion of N3 was significantly different between the two groups(χ2=4.388,P=0.036).The patients with high expression of Ki-67 in the two groups were 47(92.2%)cases and 446(79.9%)cases,respectively.The high expression of Ki-67 in the young group was significantly increased(χ2=4.532,P=0.033).There was no significant difference in the expression of Estrogen Receptor(ER),Progesterone Receptor(PgR),Human Epidermal Growth Factor Receptor-2(HER2),and P53(P>0.05).The most common subtypes of molecular classification in invasive carcinoma in the two groups were Luminal B type,with 21(41.2%)and 287(51.4%)cases,respectively.Patients with Triple-Negative Breast Cancers(TNBC)were 12(23.5%)cases and 73(13.1%)cases,respectively.The proportion of young patients with TNBC was significantly higher(χ2=4.427,P=0.039).There was no significant difference in the incidence of Luminal A,Luminal B and HER2-positive breast cancer between the two groups(P>0.05).Conclusions:1.Family history of direct tumors in breast cancer patients younger than 35 years may be higher;2.Delayed diagnosis of breast cancer patients younger than 35 years may lead to later tumor stage;3.The pathological features of breast cancer patients younger than 35 years old may be worse,the stage is later,and the invasion is stronger.