Publication: Risk factor of young breast cancer: A multicenter study
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Date
2023
Authors
Puaad, Mohd Fakhruddin Mohd
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Abstract
Introduction Young breast cancer is defined as breast cancer that developed before 40 years old. It differs to its older counterpart in terms of risk factors, biological characteristics, and prognosis. This study aims to investigate the risk factors of developing breast cancer among young breast cancer patients in Malaysia for a period of 7 years. Method This is a retrospective case-control study involving young breast cancer patients who had treatment from January 2015 till December 2021 in Kelantan and Pulau Pinang, Malaysia. It is designed as a 1 case:1 control ratio study. Patients who fulfill the inclusion and exclusion for both case and control were recruited. The demographics, risk factors and clinic-pathological data were collected and compiled. Simple and multiple logistic regression were performed. Variables with p-value less than 0.05 are considered as significant. Result A total of 268 patients were recruited into this study. Each arm has 134 patients. Most of our young breast cancer patient are Malay 86.6% (n =116) followed by Chinese 9% (n=12), Indian 2% (n=3) and others 2% (n =3). Mean age of diagnosis is 34.3 years old. Main symptom at presentation is breast lump 88.8% (n=119) followed by mastalgia 7.5% (n=10), nipple discharge 6.7% (n=9), nipple retraction 3% (n=4) and mastitis 0.7% (n=1). Most of our patients have late stage disease as 17.2% (n=23) were in stage 3 and 47.8% (n=64) in stage 4. In terms of treatment, 106 (79.1%) patients had chemotherapy either as adjuvant, neoadjuvant or with palliative intent. 116 (86.5%) had surgery while 18 (13.5%) did not have any surgical intervention. Most patients underwent mastectomy and axillary clearance (57.9%). For the risk factors of young breast cancer, multiple logistic regression concluded that there are only 3 variables with significant association with young breast cancer. The variables are age at diagnosis (aOR 1.07, p-value 0.0034, duration of noticing symptom (aOR 1.25,1.08,1.48, p-value 0.01,0.038,0.017) and history of taking oral contraceptive pills (aOR 1.9, p-value 0.041). Conclusion Young breast cancer mostly present as a late stage (stage 3 & stage 4) disease. The risk factors of post-menopausal breast cancer cannot be applied to this group of patient as only few of the established risk factors were significant in our study.
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Keywords
Young breast cancer , risk factor