Though breast cancer is less common in young women, it still occurs and may often be delayed in diagnosis, leading to more aggressive cancers, according to a Thursday session.
“Early diagnosis ensures optimal treatment, hopefully improving not only survival, but functionality of this very important group of our patients. Many of them are already mothers or otherwise want to preserve their fertility and their well-being affects whole families in a more profound manner than our older patients,” said Sepideh Sefidbakht, MD, associate professor of radiology at Shiraz University of Medical Sciences in Iran.
Review Over 20 Years
The research team performed a retrospective search on Breast Cancer Registry Data and also their PACS system for the clinical, imaging and pathological characteristics of breast cancer presenting in younger women over a 20-year time period, from 2001 to 2020. Patients were between the ages of 18-30 years old. Data reviewed included pathologic data such as nuclear subtype, nuclear grade, tumor stage, presence of in situ cancer, and imaging data including lesion type in mammogram and ultrasound.
Researchers found a relatively higher number of more aggressive cancers, such as triple negative cancers in younger women, and also a higher number of atypical presentations, such as relatively circumscribed masses.
Breast Cancer in Younger Women and Delayed Diagnosis
Dr. Sefidbakht said the team was surprised by the number of young women affected by breast cancer in their everyday clinical practice and concerned about the delayed diagnosis, which seemed more prevalent in younger women who do not undergo regular screening for breast cancer as is more common in older women.
“For breast cancer, delayed diagnosis can make the difference between a longer survival time and enjoying a more active and functional life. In younger women, the delayed diagnosis is more common because of a lower index of suspicion among clinicians and radiologists,” Dr. Sefidbakht said. “Understanding the differences between the clinical, pathological, and imaging characteristics of breast cancer between the very young women with breast cancer could potentially help us avoid costly delays in diagnosis.”
A larger, multicenter trial could help validate findings from this project and could point to ways to speed up diagnosis and improve outcomes for younger women with breast cancer.
Encouraging Young Women to Take Breast Masses Seriously
Dr. Sefidbakht said that she hopes her presentation can remind radiologists that younger women can be affected by breast cancer and to keep in mind that margins of masses need to be evaluated thoroughly with ultrasound.
“Many of our patients had masses with indistinct margins, at least in some part of the mass, that in retrospect could have been biopsied if they were properly appreciated the first time,” Dr. Sefidbakht said.
Access the presentation, “Imaging Breast Cancer in Young Women: A Report on 342 Patients 30 Years old or Younger,” (R6-SSBR11-1) on demand at Meeting.RSNA.org.
