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BMC Women's Health
Published in: BMC Women's Health 1/2017

Open Access 01-12-2017 | Research article

Clinicopathologic and prognostic features of breast cancer in young women: a series from North of Morocco

Authors: Joaira Bakkach, Mohamed Mansouri, Touria Derkaoui, Ali Loudiyi, Mohamed Fihri, Samia Hassani, Amina Barakat, Naima Ghailani Nourouti, Mohcine Bennani Mechita

Published in: BMC Women's Health | Issue 1/2017

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Abstract

Background

Literature data reported a higher frequency of breast cancer in young women (BCYW) in developing countries. BCYW is associated with delayed diagnosis, aggressive biology and poor prognosis. However, our knowledge of biological profile, treatment received and outcome of young patients is still limited in Morocco. We propose to analyze clinicopathologic, therapeutic and prognostic features of BCYW among a series of patients native and/or inhabitant of North of Morocco.

Methods

We carried out a retro-prospective study of 331 infiltrating breast cancer cases registered between January 2010 and December 2015. Details of tumor pathology, treatment and outcome were collected. Disease-Free Survival (DFS) and Overall Survival (OS) were assessed by Kaplan-Meier analysis.

Results

A total of 82 patients were diagnosed with breast cancer at the age of 40 or younger (24.8%). Median age was 36 years. More than one quarter (26%) of patients had family history of breast or ovarian cancer. Advanced stages accounted for 34.2% of cases. Median tumor diameter was 2.8 cm. Intermediate and high-grade tumors represented 47.6% and 40.2%, respectively. Nodal involvement was present in 58.5% and lymphovascular invasion was found in 47.7% of the patients. About two thirds (66.2%) of tumors were hormone receptor positive, 29.2% over-expressed HER2 receptor and 23% were triple negative. Patients underwent breast conserving surgery in 38.2% of cases, 61.7% were offered adjuvant chemotherapy and 84.6% received hormone therapy. Five-year DFS and OS were respectively 88.9% and 75.6%. Locoregional recurrence occurred in 2.8% of cases and 8.3% of patients developed distant metastases.

Conclusion

Our findings are in accordance with previous studies that have shown a higher frequency of breast cancer among Moroccan young women. In line with literature data, clinicopathologic profile seems to be aggressive and prognosis is pejorative in our series.
Literature
1.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC Cancer Base no. 11. Lyon: International Agency for Research on Cancer; 2013. http://​globocan.​iarc.​fr. Accessed 10 Nov 2016.
2.
3.
Abahssin H, Lalya I, EL M’Rabet FZ, Ismaili N, Razine R, Adnane Tazi M, et al. Breast cancer in moroccan young women: a retrospective study. BMC Res Notes. 2010;3:1.CrossRef
4.
Boufettal H, Noun M, Samouh N. Breast cancer in young patient in Morocco. Cancer Radiother. 2010;14:698–703.CrossRefPubMed
5.
Znati K, Bennis S, Abbass F, Akasbi Y, Chbani L, Elfatemi H, et al. Breast cancer in young patient in Morocco. Gynecol Obstet Fertil. 2014;42:149–54.
6.
Slaoui M, Mouh FZ, Ghanname I, Razine R, El Mzibri M, Amrani M. Outcome of Breast Cancer in Moroccan Young Women Correlated to Clinic-Pathological Features, Risk Factors and Treatment: A Comparative Study of 716 Cases in a Single Institution. PLoS One. 2016;11:e0164841.CrossRefPubMedPubMedCentral
7.
DeSantis C, Ma J, Bryan L, Jemal A. Breast cancer statistics, 2013. CA Cancer J Clin. 2014;64:52–62.CrossRefPubMed
8.
Gabriel CA, Domchek SM. Breast cancer in young women. Breast Cancer Res. 2010;12:1.CrossRef
9.
Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E. Breast cancer in young women: clinicopathological features and biological specificity. Breast. 2003;12:247–50.
10.
Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008;26:3324–30.
11.
Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA. Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. J Am Coll Surg. 2009;208:341–7.
12.
Bharat A, Aft RL, Gao F, Margenthaler JA. Patient and tumor characteristics associated with increased mortality in young women (≤ 40 years) with breast cancer. J Surg Oncol. 2009;100:248–51.
13.
Fredholm H, Eaker S, Frisell J, Holmberg L, Fredriksson I, Lindman H. Breast cancer in young women: poor survival despite intensive treatment. PLoS One. 2009;4:e7695.CrossRefPubMedPubMedCentral
14.
Morrison DH, Rahardja D, King E, Peng Y, Sarode VR. Tumour biomarker expression relative to age and molecular subtypes of invasive breast cancer. Br J Cancer. 2012;107:382–7.
15.
Karihtala P, Winqvist R, Bloigu R, Jukkola-Vuorinen A. Long-term observational follow-up study of breast cancer diagnosed in women ≤ 40 years old. Breast. 2010;19:456–61.
16.
Collins LC, Marotti JD, Gelber S, Cole K, Ruddy K, Kereakoglow S, et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat. 2012;131:1061–6.
17.
Copson E, Eccles B, Maishman T, Gerty S, Stanton L, Cutress RI, et al. Prospective observational study of breast cancer treatment outcomes for UK women aged 18-40 years at diagnosis: the POSH study. J Natl Cancer Inst. 2013;105:978–88.
18.
De la Rochefordière A, Asselain B, Campana F, Scholl SM, Frenton J, Vilcoq JR, et al. Age as prognostic factor in premenopausal breast carcinoma. Lancet. 1993;341:1039–43.
19.
Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY. Do young breast cancer patients have worse outcomes? J Surg Res. 2003;113:109–113.
20.
Anders CK, Fan C, Parker JS, Carey LA, Blackwell KL, Klauber-DeMore N, et al. Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes? J Clin Oncol. 2011;29:e18–20.CrossRefPubMed
21.
Colleoni M, Anders CK. Debate: the biology of breast cancer in young women is unique. Oncologist. 2013;18:e13–e15.
22.
De Sanjosé S, Léoné M, Bérez V, Izquierdo A, Font R, Brunet JM, et al. Prevalence of BRCA1 and BRCA2 germline mutations in young breast cancer patients: a population-based study: BRCA and breast cancer in young women. Int J Cancer. 2003;106:588–93.
23.
Rouba A, Kaisi N, Al-Chaty E, Badin R, Pals G, Young C, et al. Patterns of allelic loss at the BRCA1 locus in Arabic women with breast cancer. Int J Mol Med. 2000;6:565–9.
24.
Uhrhammer N, Abdelouahab A, Lafarge L, Feillel V, Ben Dib A, Bignon Y-J. BRCA1 mutations in Algerian breast cancer patients: high frequency in young, sporadic cases. Int J Med Sci. 2008;5:197–202.CrossRefPubMedPubMedCentral
25.
Bhikoo R, Srinivasa S, Yu T.-C, Moss D, Hill AG. Systematic review of breast cancer biology in developing countries (part 1): Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. Cancers. 2011;3:2358–2381.
26.
Bhikoo R, Srinivasa S, Yu T.-C, Moss D, Hill AG. Systematic review of breast cancer biology in developing countries (part 2): Asian subcontinent and South East Asia. Cancers 2011;3:2382–2401.
27.
Najjar H, Easson A. Age at diagnosis of breast cancer in Arab nations. Int J Surg. 2010;8:448–52.
28.
29.
Corbex M, Bouzbid S, Boffetta P. Features of breast cancer in developing countries, examples from North-Africa. Eur J Cancer. 2014;50:1808–18.
30.
Ghiasvand R, Adami H-O, Harirchi I, Akrami R, Zendehdel K. Higher incidence of premenopausal breast cancer in less developed countries; myth or truth? BMC Cancer. 2014;14:1.CrossRef
31.
Laraqui A, Uhrhammer N, Lahlou-Amine I, EL Rhaffouli H, El Baghdadi J, Dehayni M, et al. Mutation screening of the BRCA1 gene in early onset and familial breast/ovarian cancer in Moroccan population. Int J Med Sci. 2013;10:60–7.
32.
Tazzite A, Nadiffi S, Kottwitz D, El Amrani M, Jouhadi H, Benider A, et al. Specific BRCA1 gene variations amongst young Moroccan breast cancer patients. Genet Mol Res. 2014;13:791–8.
33.
34.
Collaborative Group on Hormonal Factors in Breast Cancer. Familial breast cancer. collaborative reanalysis of individual data from 52 epidemiological studies including 58 209 women with breast cancer and 101 986 women without the disease. Lancet. 2001;358:1389–99.
35.
Loman N, Johannsson O, Kristoffersson U, Olsson H, Borg Ǻ. Family history of breast and ovarian cancers and BRCA1 and BRCA2 mutations in a population-based series of early-onset breast cancer. J Natl Cancer Inst. 2001;93:1215–23.
36.
Rosenberg SM, Ruddy KJ, Tamimi RM, Gelber S, Schapira L, Come S, et al. BRCA1 and BRCA2 mutation testing in young women with breast cancer. JAMA Oncol. 2016;2:730–6.
37.
Evans DG, Barwell J, Eccles DM, Collins A, Izatt L, Jacobs C, et al. The Angelina Jolie effect: how high celebrity profile can have a major impact on provision of cancer related services. Breast Cancer Res. 2014;16:1.CrossRef
38.
Raphael J, Verma S, Hewitt P, Eisen A. The impact of Angelina Jolie (AJ)‘s story on genetic referral and testing at an academic cancer Centre in Canada. J Genet Couns. 2016;25:1309–16.
39.
Teebi AS. Genetic disorders among Arab populations. 2nd ed. Berlin, Heidelberg, Germany: Springer-Verlag; 2010.CrossRef
40.
Alran S, Rousset-Jablonski C. Particularités du cancer du sein chez la femme jeune. Réal.En Gynécologie-Obstétrique. 2013;21–26.
41.
National Comprehensive Cancer Network (NCCN) Clinical Practices Guidelines in Oncology. genetic/familial high-risk assessment: breast and ovarian. Version 1.2017-2016. http://​www.​nccn.​org. Accessed 10 Nov 2016.
42.
Malone KE, Begg CB, Haile RW, Borg A, Concannon P, Tellhed L, et al. Population-based study of the risk of second primary Contralateral breast cancer associated with carrying a mutation in BRCA1 or BRCA2. J Clin Oncol. 2010;28:2404–10.
43.
Huo D, Melkonian S, Rathouz PJ, Khramtsov A, Olopade OI. Concordance in histological and biological parameters between first and second primary breast cancers. Cancer. 2011;117:907–15.
44.
Coates AS, Winer EP, Goldhirsch A, Gelber RD, Gnant M, Piccart-Gebhart M, et al. Tailoring therapies-improving the management of early breast cancer: St Gallen international expert consensus on the primary therapy of early breast cancer 2015. Ann Oncol. 2015;26:1533–46.
45.
Keegan TH, DeRouen MC, Press DJ, Kurian AW, Clarke CA. Occurrence of breast cancer subtypes in adolescent and young adult women. Breast Cancer Res. 2012;14:1.CrossRef
46.
Derkaoui T, Bakkach J, Mansouri M, Loudiyi A, Fihri M, Alaoui FZ, et al. Triple negative breast cancer in north of Morocco: clinicopathologic and prognostic features. BMC Womens Health. 2016;16:68.CrossRefPubMedPubMedCentral
47.
Kroman N, Holtveg H, Wohlfahrt J, Jensen MB, Mouridsen HT, Blichert-Toft M, et al. Effect of breast-conserving therapy versus radical mastectomy on prognosis for young women with breast carcinoma. Cancer. 2004;100:688–93.
48.
Vila J, Gandini S, Gentilini O. Overall survival according to type of surgery in young (≤40 years) early breast cancer patients: a systematic meta-analysis comparing breast-conserving surgery versus mastectomy. Breast. 2015;24:175–81.
49.
Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.CrossRefPubMed
50.
Krämer S, Schulz-Wendtland R, Hagedorn K, Bautz W, Lang N. Magnetic resonance imaging in the diagnosis of local recurrences in breast cancer. Anticancer Res. 1998;18:2159–61.
51.
Chung M, Chang HR, Bland KI, Wanebo HJ. Younger women with breast carcinoma have a poorer prognosis than older women. Cancer. 1996;77:97–103.CrossRefPubMed
52.
Buckley JM, Coopey S, Samphao S, Specht MC, Hughes KS, Gadd M, et al. Recurrence rates and long-term survival in women diagnosed with breast cancer at age 40 and younger. J Clin Oncol. 2011;29 suppl 27:70–70.
53.
Plichta JK, Rai U, Tang R, Coopey SB, Buckley JM, Gadd MA, et al. Factors associated with recurrence rates and long-term survival in women diagnosed with breast cancer ages 40 and younger. Ann Surg Oncol. 2016;23:3212–20.
Metadata
Title
Clinicopathologic and prognostic features of breast cancer in young women: a series from North of Morocco
Authors
Joaira Bakkach
Mohamed Mansouri
Touria Derkaoui
Ali Loudiyi
Mohamed Fihri
Samia Hassani
Amina Barakat
Naima Ghailani Nourouti
Mohcine Bennani Mechita
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2017
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-017-0456-1

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