Histopathology of breast cancer in relation to age

Abstract

Summary Histological reports of 1869 consecutive women with invasive breast cancer have been reviewed to determine whether histological features of the tumours were related to the patients' age. The patients, treated between 1983 and 1992, were divided into four groups, based on age. There were 148 aged < 39 years, 355 aged [40][41][42][43][44][45][46][47][48][49] years, 984 aged 50-69 years and 382 aged 70 years or more. The most outstanding finding was the increase in incidence of grade IlIl infiltrating ductal carcinoma in those aged < 39 years (P< 0.0001). Certain tumour types, in particular lobular, were reported more frequently in the oldest age group. Additionally, there was a significant reduction of axillary lymph node metastases, vascular invasion and lymphoplasmacytic stromal reaction with increasing age, all of which were independent of tumour grade. These data suggest that there may be age-related changes in the histology of breast cancer and, in some cases, less aggressive features in the elderly. However, as the life expectancy of women over the age of 70 may be many years, treatment should be based on histological prognostic features of the primary tumour rather than age alone.Keywords: breast cancer; histology; age; tumour grade; axillary nodes There are reports indicating that breast cancer has a relatively unfavourable prognosis in young women (Jacquemier et al, 1985;Rosen et al, 1985;Rochefordiere et al, 1993), but is a disease of good prognosis among the elderly (Rosen et al, 1985). However, others have suggested that age does not influence the behaviour of the disease (Schaefer et al, 1984). Relatively few comparative studies of histological features of breast cancer in the young and old have been conducted. It has been reported that there is a significantly lower mean age for patients with medullary carcinoma, while lobular and mucoid carcinomas are relatively more frequent in the elderly (Rosen et al, 1985). Intracystic papillary carcinoma is also found more frequently in older women (Carter et al, 1983). In addition, it has been suggested that younger women have more aggressive high-grade tumours than the elderly (Jacquemier et al, 1985;Rosen et al, 1985).The aim of the present investigation was to review a large series of patients with invasive breast cancer and to analyse a variety of histopathological findings in relation to age, in order to determine whether there were any indications of less or more aggressive features in different age groups. PATIENTS AND METHODSThe study comprised 1869 women with invasive breast cancer who were treated consecutively at the Breast Unit, Guy's Hospital, in the 10-year period 1983-1992. The patients were divided into four age groups, < 39 years, 40-49 years, 50-69 years and > 70 years. These age groups were selected for the following reasons.The cut-off age for young women has ranged from 30-45 years in previous studies (Jacquemier et al, 1985;Rosen et al, 1985;Lee et al, 1992 Correspondence to: IS Fentiman reasonable size, which was compatible with ...

Trends in Epidemiology, Clinical and Histopathological Characteristics of Breast Cancer in Iran: Results of a 17 Year Study

“…This 10 years earlier peak incidence age for Iranian women is different from developed countries (Parkin and Fernandez, 2006;Smigal et al, 2006) but resembles to developing nations (Agarwal et al, 2007) and corresponds with other studies done in Iran (Mousavi et al, 2007;2008;Harirchi et al, 2011). Some biomarker studies and clinical data point that lateonset BC is biologically less aggressive with a slower growth than early-onset (Fisher et al, 1997;Benz, 2008). The current study has supported this idea to some extent.…”

“…Also, subjects were stratified into five age groups: ≤40 years, 41-50 years, 51-60 years, 61-70 years, and 71≤ years. Cut-off age for young women has varied from 35-40 years in some studies (Fisher et al,1997;Colleoni et al, 2002;Harirchi et al, 2011). We selected 40 years or under, since it provided a group of reasonable size which was compatible with other studies.…”

Breast carcinoma in women age 25 years or less

“…One third of operable cases with invasive disease in the current series had metastatic disease in their axillary nodes at diagnosis, which is not as high as Fisher et al, who reported lymph node involvement in 60% of patients aged Ͻ 39 years, 17 Bertheau (65%), 18 Walker in 69% of patients under 30, 9 or Kim et al, who found a 48% node positive rate in patients under 35. 7 The incidence of node positivity in very young women was not statistically different from those aged between 26 and 35 years, which suggests that the low figure of 33% is a reflection of the small sample size.…”

Hormone receptors and proliferation in breast carcinomas of equivalent histologic grades in pre‐ and postmenopausal women

“…If these carcinomas had not been selected in this manner, a higher percentage of high-grade carcinomas would be expected in the premenopausal group and a lower percentage expected in the postmenopausal group. 27,28 In spite of this selection process, the younger, premenopausal group of carcinomas had a higher stage (greater than stage I; p ϭ 0.003), a greater incidence of positive lymph nodes (p ϭ 0.041) and larger tumors (p Ͻ 0.001). There was a higher percentage of Caucasian women (84%) than African American women (16%) who were premenopausal and Յ45 (p ϭ 0.012).…”

“…Also, comparisons of the pathology of breast carcinomas have demonstrated that there is a greater proportion of high-grade carcinomas in young women (younger than 40 years) 27,28 and that special histologic types of invasive carcinoma (e.g., mucinous and papillary carcinomas) with more favorable prognoses than the more common infiltrating ductal carcinoma are more prevalent in older than younger populations. 29,30 However, histologic grade and type are closely related to the presence of other prognostic markers, including ER, rate of cell proliferation and p53 status.…”