Razia Bano graduated from medical school in November 2007, completed my house job in 2009, certified as a general surgeon in November 2013, then got enrolled in 2 years Fellowship in Breast Surgery at Shaukat Khanum Memorial Cancer Hospital & Research Centre Lahore .Razia Bano is a member of American Society of Breast Surgeons since 2015 . After finishing of my fellowship in breast surgery in November 2015, I have established. A dedicated Breast Surgery Department at ( Combined Military Hospital Rawalpindi since January 2016)
Background: Breast cancer diagnosed at younger age has aggressive biology being triple negative and high grade and associated with poor prognosis .
Patients and Methods: Retrospectively data of 121 patients age 30 years or younger registered during the year 2008 was reviewed. Data was extracted from the cancer registry department of the institute. Demographics studied were age at diagnosis, gender, pregnancy or lactation associated, family history , histopathological diagnosis, stage of the disease, receptors, type of treatment, response, local recurrence, distant relapse, survival.
Results : Only single patient was male. The age range was from 20 -30 years, only a single patient had bilateral involvement. Almost half 50.4%(n=61) patients had locally advanced disease at presentation. Pregnancy/ lactation associated breast cancer was seen in 29.8%(n=36). The most common stage was stage III (52.1%) & stage II (33.9%). Invasive ductal carcinoma was the most common histology 94.2% (n=114)patients, the Triple negative was the most common molecular subtype present in 46.3%(56). Chemotherapy was received by 92.6%(n=112), 88.4%(n=107)patients received radiation therapy to the breast & supraclavicular field . Modified radical mastectomy was performed in 57%(n=69) , breast conservation surgery in 35.5%(n=43), after 5 years follow-up ,local recurrence was observed in 12.4%(n=15) , cancer-related deaths were 42.1%(n=51).
Conclusions: Breast cancer in very young has very aggressive tumor biology , needs aggressive treatment with surgery , chemotherapy, radiation therapy and hormonal therapy, furthermore there is the need to identify possible environmental factors which may contribute to the rising incidence in this age group.