BREAST CANCER UNDER 40: A STUDY OF 31 CASES

Mounir Moukit*, Aymane Ouaryaghli, Mohamed Rahmoune, Ismail Allilou and Abdellah Babahabib

ABSTRACT

Introduction: In Morocco, breast cancer is the most common cancer among women, with a rate of 36%. The occurrence of this cancer at a young age is often associated with anatomoclinical characteristics of poor prognosis. Methods: This is a retrospective study of a series of 31 cases of breast cancer in young women under the age of 40 who were admitted for treatment at the Moulay Ismail Military Hospital in Meknes between January 2019 and September 2023. Results: Breast cancer in women under 40 years old accounted for 11% of the total number of breast cancer cases diagnosed during this period, with an average age of 32 years and a peak frequency in the 31-35 age group (42%). Pauciparity and nulliparity were predominant (55% / 26%). A family history of breast cancer was reported in 31% of cases. Oral contraceptive use was noted in 72% of the patients. Clinically, the average consultation delay was three months. The most frequent mode of discovery was self-palpation of a breast lump, found in 82% of cases. The left breast was affected in 58% of patients. On the paraclinical level, among the patients who underwent ultrasound-mammography, 59% were classified as ACR4 and 41% as ACR5. Histologically, there was a clear predominance of infiltrating ductal carcinoma, accounting for 94% of cases, with an average tumor size of 3.5 cm. SBR grade II and III tumors were present in 100% of cases accompanied by vascular emboli in 34% of cases. Histological lymph node involvement was found in 71% of patients. Regarding molecular studies, HER2 overexpression was found in 22% of cases, and the triple-negative subtype in 26% of cases. Therapeutically, 67% of patients underwent radical surgery, 23% underwent conservative surgery, and 10% received palliative treatment. From a prognostic perspective, in our series, the overall survival rate for two years was 69%, while the five-year survival rate was 17%. Conclusion: A young age is often associated with unfavorable anatomo-clinical and prognostic characteristics. It is therefore essential to adopt a multidisciplinary approach aimed at diagnosing the disease earlier and tailoring treatments based on prognostic factors specific to young patients, to improve survival.

Keywords: Breast cancer; Young woman; Prognostic factors.