BackgroundBreast cancer in very young patients represents a unique issue that needs more attention as the number of cases is increasing and it has special characteristics at presentation, diagnosis, and biologic behaviors which reflect on both treatment strategies and survival. The aim of the current study was to analyze and report the clinico-pathological characteristics and treatment procedures used for breast cancer in very young patients over the last decade in a single Egyptian cancer center.Patients and methodsA retrospective study was conducted in the Oncology Center – Mansoura University, where the data of all breast cancer patients, between September 2006 and August 2015, were reviewed. Among 4,628 patients who were diagnosed with breast cancer during this period, only 300 patients aged ≤35 years had complete registry data. Clinico-pathological characteristics, therapeutic procedures, and survival outcome were reported.ResultsThree hundred and seventy-nine patients (8.19%) were aged ≤35 years at the time of presentation. The age ranged between 21 and 35 years, and the mean age was 31 years (±3 standard deviation). Positive family history of breast cancer was found in 12.3%, and metastatic presentation was seen in 4.7%. The rate of axillary lymph nodes involvement was 75.7%. The estrogen receptor-negative disease was found in 51%, and among 217 patients who did HER2 test, 82 patients (37.8%) were HER2 positive, while triple-negative subtype was found in 57 patients (26.4%). Ki 67 percentage ranged between 3% and 66% (median was 35%). The median disease-free survival was 61 months (95% confidence interval 44–78 months); the 3-year and 5-year disease-free survival were 58% and 50%, respectively. The 3-year and 5-year overall survival were 88% and 68%, respectively.ConclusionVery young Egyptian patients with breast cancer should be given focus and specially studied as the presentation has more aggressive biologic behavior at advanced stages, so the treatment strategies have to be tailored in a very precise manner.

BackgroundAlthough therapeutic mammoplasty (TM) was introduced for treatment of localized ductal carcinoma in situ and invasive breast carcinoma (stages I and II) in females with large breast size, the suitability of medial pedicle TM for treatment of breast tumors at different locations has not been established. The objective of this study was to assess the safety and esthetic outcome of medial pedicle TM for breast tumors at different locations.MethodsThe study was conducted from February 2012 to July 2014. Consecutive patients with early breast carcinoma with medium- and large-sized breasts, with or without ptosis, who were offered medial pedicle TM were included in the study. Patients who were not candidates for breast-conserving surgery or those with tumors located along the medial pedicle were excluded. All patients received immediate postoperative adjuvant chemoradiotherapy.ResultsThirty patients with a mean age of 48.5 years received medial pedicle TM in the breast harboring the tumor or, additionally, the other breast (N=14). The tumors were in the upper (60.0%), lower (26.7%), and lateral (13.3%) quadrants. Minor complications occurred in five cases (5/30, 16.7%) in the ipsilateral and in two (2/14, 14.3%) contralateral breasts. No wound dehiscence or areolar necrosis was recorded. A total of 22 (73.3%) patients were scored as excellent cosmesis. After a median follow-up of 20 months, no locoregional recurrence or distant metastases were observed.ConclusionTM using a medial pedicle is a safe and appealing technique among women with tumors at different locations.

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