Background: Early onset breast cancer is associated with poor outcomes but variable results have been reported.1, 2 It is a significant problem in Pakistani women but remains under reported. Breast conservation plays an important role in surgical management of this younger patient group.
Aim: To determine outcome of breast conservative therapy in early onset breast cancer in Pakistani population and compare it with older counterparts.
Methods: A review of patients with invasive breast cancer who underwent breast conservation at Shaukat Khanum Cancer Hospital between 1997-2009 was performed. Patients were divided into two groups i.e. Group I age ≤ 40 and Group II > 40 years. A total of 401 patients with breast cancer were identified in Group I and 405 patients in Group II. Demographics, histopathological findings and receptor status of two groups were compared. Chi square test was used for categorical variables. Outcome was assessed on basis of 10 year locoregional recurrence free survival (LRRFS), disease free survival (DFS) and overall survival (OS) in two groups. For survival analysis Kaplan Meier curves were used and significance was determined using Log rank test. Cox hazard model was used to determine independent predictors of outcome.
Results: Median follow up was 4.31(0.1-15.5) years. Median age at presentation was 34.6 years (17-40) and 51.89 years (41-82) for two groups. Groups were significantly different from each other with respect to grade, receptor status, tumor stage and use of neoadjuvant therapy. No significant difference was present between the two groups for estimated 10 year LRRFS (86% vs. 95%) (P=0.1), DFS (70% vs. 70%) (P=0.5) and OS (75% vs. 63%) (P=0.1). On multivariate analysis, tumor stage was an independent predictor of LRRFS, DFS and OS.
Conclusions: Early onset breast cancer is associated with a distinct biology but does not lead to poorer outcomes in our population.