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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(02): 323-332
DOI: 10.1055/s-0041-1734342
Original Article

Clinico-radio-pathological Features and Biological Behavior of Breast Cancer in Young Indian Women: A Prospective Study

Rashmi Sudhir
1   Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
,
Kamala Sannapareddy
1   Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
,
Alekya Potlapalli
1   Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
,
Vidhatri Penmetsa
1   Department of Radio-Diagnosis, Basavatarkam Indo-American Cancer Hospital and Research Centre, Hyderabad, Telangana, India
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Abstract

Aims The aim of the study is to evaluate the characteristic imaging features of breast cancer on mammogram, ultrasound, and magnetic resonance imaging (MRI) in women less than 40 years of age and to assess the degree of correlation between clinico-radio-pathological features and biological behavior.

Methods and Materials A prospective observational study on consecutive women under 40 years of age evaluated with ultrasound of breast, digital mammogram, or contrast-enhanced breast MRI, diagnosed with breast cancer on histopathology and molecular analysis done at our center between January and December 2019 were included. Patient demographics, clinical presentation, family history, BRCA mutation status, imaging, pathological findings, and molecular status were determined.

Results Out of 2,470 women diagnosed with breast cancer, 354 (14.3%) were less than 40 years of age who were included in this study. Mammography showed positive findings in 85%, ultrasonography in 94.3%, and MRI in 96.4% of women. Majority of the women (69.6%) presented in the late stage (Stage III and IV) with high-grade carcinoma in 39.5% and triple-negative breast cancer (TNBC) in 45.7%. Tumors with human epidermal growth factor-2neu expression were associated with the presence of microcalcifications (p-value = 0.006), and TNBC with circumscribed margins or BI-RADS 3/4a category on imaging (p-value = 0.007) and high-grade invasive carcinoma compared with others (p-value <0.0001).

Conclusion The incidence of breast cancer in Indian women less than 40 years of age is relatively high as compared with the West. The detection of breast cancer in young women remains challenging due to dense breast tissue, lower incidence rate, and lack of regular breast screening. While ultrasound is the recommended imaging method for evaluation of breast under the age of 40 years, we found a better characterization of lesions and higher cancer detection rates when they were also evaluated with mammography and MRI.

Keywords

breast cancer - biological behavior - imaging - pathology - Indian women


Publication History

Article published online:
30 July 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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