breast cancer characteristics

In 1999, 89 Australian women aged younger than 40 years and 347 women agedbetween 40 and 49 years died from breast cancer (see Table 1). Over the fouryear period between 1992 and 1996, the risk of death from breast cancer was 1 in 27,517 for women aged less than 30 years, 1 in 1,317 for women aged 30 to 39 years, and 1 in 366 for women aged 40 to 49 years.11 Breast cancer mortality for younger women remained relatively stable over the ten-year period between 1986 and 1996.11

Breast cancers in younger women have a different distribution of pathological features. While there are some inconsistent findings across studies, overall there appears to be an increased incidence of several features that have been shown to predict adverse outcomes. These include larger tumour size, more positive nodes, negative steroid hormone receptors and higher histological grade.20,21, Poorer outcomes for younger women could be partly due to differences in these prognostic factors.There is little published population-based research to clarify the impact of young age on disease outcome; however, two well conducted studies have concluded that young age is an adverse predictor of disease outcome in certain subgroups. A Danish study found that although age was an independent predictor of outcome, the negative effect of young age was almost exclusively seen in women classified as having low-risk disease who did not
receive adjuvant therapy.17 A report from the International Breast Cancer Study Group (IBCSG)15 provided data about 3,700 pre- or perimenopausal women with early stage breast cancer who received adjuvant chemotherapy in successive randomised trials between 1978 and 1993. Women aged younger than 35 had significantly shorter disease-free survival than older women and, among the younger women, positive oestrogen receptor status was associated with a particularly high risk of recurrence, possibly related to the absence of treatment with endocrine therapy.