Abstract 245P
Background
There is a general consensus for mammography screening to detect breast cancers (BC) at a pre-clinical stage for women aged 50–69 years and some groups with risk factors as familiar cancer or previous radiotherapy. Evidence in younger women is more limited but BC diagnosis in asymptomatic patients it's still common and its clinical impact is unknown.
Methods
We conducted a retrospective study selecting patients ≤45 years with BC diagnosis in the Breast Cancer Unit of the Puerta de Hierro Hospital between 2014 and 2019. Epidemiological, pathological and treatment information was collected. We explored the differences between asymptomatic women and those who consulted for symptoms.
Results
From a database of 2270 women within situ or infiltrating BC, we select 372 patients ≤45 years and divided them by clinical at diagnosis, symptomatic vs. asymptomatic (screening). Table: 245P
| Symptomatic % | Asymptomatic % | All | Univariate analysis: p | |
| n (%) | 266 (71,5) | 106 (28,5) | 372 | |
| Age (IQR) | 40,3 (37,2 – 43,8) | 41 (38,8 – 44,1) | 40,5 (37,8 – 43,9) | |
| In situ / Invasive BC | 4,9 / 95,1 | 24,5 / 75,5 | 10,7 / 83,3 | p < 0.000 |
| FA breast | 27,4 | 45,3 | 32,1 | p = 0,001 |
| FA ovary | 4,51 | 4,72 | 4,36 | p = 0,920 |
| BRCA1/2 carrier | 5,26 | 13,21 | 7,18 | p = 0,013 |
| Stage | p = 0,002 | |||
| I | 31,9 | 54 | 37,3 | |
| II | 39,9 | 31,6 | 37,6 | |
| III | 21,2 | 6,6 | 18,2 | |
| IV | 5,3 | 4 | 4,8 | |
| Axillary staging + | 48 | 29,2 | 43,8 | p = 0,004 |
| Subtypes | p = 0,071 | |||
| Triple Negative | 13,8 | 4,2 | 11,2 | |
| RRHH+ HER2- | 66,1 | 79,1 | 69.5 | |
| RRHH+ HER2+ | 14,2 | 13,9 | 14,3 | |
| RRHH- HER2+ | 5,9 | 2,8 | 5 | |
| Treatment | ||||
| Neoadjuvant CT | 36,8 | 16,3 | 31 | p = 0,001 |
| CT (neo or adjuvant) | 73,3 | 51,3 | 68,5 | p < 0,000 |
| Mastectomy | 66,8 | 68 | 67,2 | p = 0,850 |
| Lymphadenectomy | 58,7 | 27,8 | 52 | p < 0,000 |
Conclusions
Clinical and treatment differences have been observed in association with the presence of symptoms. There is no consensus in performing BC screening in women <50, but an early detection adapting it to the risk could achieve an earlier detection at a lower stage, decrease the aggressiveness of cancer treatment and increase the chances of cure.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.