Breast Cancer in Women under 30 is Highly Aggressive with Extremely Low Frequency: a Case Report

Abstract

SOJ ImmunologyOpen Access Case Report edema of the skin, showing a thick consistency in the central and lower quadrants, being sensitive to touch. 3 palpable lymph nodes were found in the right armpit, having a diameter between 1 cm and 2.5 cm, with a thick consistency. Ultrasonography revealed the presence of a non-homogenous glandular tissue of the right breast, with four solid nodes, non-homogeneous, with unclearly defined calcifications, vascular signal of low strength visible centrally and peripherally, highly suggestive of their equivocal character; the nodes had the following size: 2.8/2 cm, 1.7/1.3 cm, 1.5/1/0.1 cm and 1/0.7 cm, in the right armpit lymph nodes were found, having diameters of max = 20 mm, with non-differentiated sinus and periphery, and arterial vascular signal of low strength. Bone scintigraphy did not reveal the presence of bone lesions.Laboratory tests indicated: Hb = 13.2 g%, WBC = 11720/ mm 3 , Urea = 36 mg%, Bt = 0.26 mg % and CA 15-3 = 40.3 U. Chest X-ray revealed no damage evolution. On November 15, 2008 axillary lymph node biopsy was done. The histopathological test confirmed a poorly differentiated massive metastatic carcinoma. The immunohistochemical test revealed the following: HER2-negative, ER-negative, PGR-positive in less than 10% of the tumor cells and SR-2 (positive). The diagnosis upon discharge was: breast cancer (inflammatory carcinoma)-stage III B (T4dN2M0) [3]. In January 2009 the patient was referred to the Oncology unit where she was given chemotherapy in 5 sequences (DOCETAXEL and EPIDOXORUBICIN) [4,5]. The response to chemotherapy was partial: the erythema wore off and the skin edema was reduced (yet a slight peau d'orange was still present). Also a right axillary lymphadenopathy relic having a diameter of 1.5 cm persisted. Under the circumstances, it was decided to change the regimen by administering EPIDOXORUBICIN + 5 FLUOROURACIL + CYCLOPHOSPHAMIDE [4,5] in 4 sequences, followed by radiotherapy 50 Gy, the evolution still being favorable (disappearance of skin edema with the involution of mammary lymph nodes and axillary adenopathy). On 22 July 2009 surgery took place in the form of mastectomy with full axillary dissection. AbstractBreast cancer occurrence is increasing worldwide; however, patients under 30 years of age who present with this condition are scarce. Using as a pretext, the "chance" to encounter a case of breast cancer patient less than 30 years of age in a hospital setting, in conjunction with the relatively few data in the literature on the topic, the current paper attempts to point out some of the features of breast carcinoma occurring in this category of patients. Basically, the paper highlights a very important aspect, namely that breast carcinoma in young women is more aggressive and shows a reserved prognosis, translated as a 5-year lower survival rate and a higher percentage of relapse following therapy compared to women in perimenopause or to elderly ones.