Clinicopathological characteristics of young versus older patients with breast cancer: A retrospective comparative study from the Madinah region of Saudi Arabia

OBJECTIVES: To compare the clinicopathological, histological and immunohistochemical features of breast cancer (BC) in between young (≤40 years) and older (>40 years) patients. METHODS: This retrospective study included histopathological reports of all patients with primary BC diagnose at the King Fahad Hospital, Madinah, Saudi Arabia between January 2006 and November 2020. RESULTS: During the study period, a total of 708 patients with BC were identified; 173 cases (24.4%) were ≤40 years old and 535 (75.6%) were above 40 years. There were significant differences in tumor size (p=0.046), tumor grade (p<0.0001), tumor stage (p=0.047), lymphovascular invasion (p<0.0001), and distant metastasis (p<0.0001) between the 2 groups. Comparing the status of the hormone receptors and molecular subtypes between the 2 age groups, BCs in the younger patients were triple–negative (p=0.008) in majority of the cases and less likely to be estrogen receptor (ER) and progesterone receptor (PR) hormone receptors–positive (p=0.0001, p<0.0001). Young patients exhibited the HER2/neu type with more frequent statistical significance (p=0.016) and the tumor type luminal A (p=0.002) with less frequent statistical significance compared to old patients. CONCLUSION: Although BC in young women is uncommon, it may be different with regards to poor prognostic outcomes, which are attributed to more aggressive histopathological features and less favorable receptor status when compared to the cases diagnosed in older women.