Archives of Breast Cancer
Volume:2 Issue: 4, Nov 2015

Breast cancer arising in young patients (≤ 40 years) is being considered as a distinct clinical entity with more aggressive tumor features and poorer survival. Our aim was to assess the impact of age on survival among a large group of Iranian women diagnosed with breast cancer. In a cross-sectional study, demographic and clinicopathological characteristics of patients with breast cancer who were treated in two referral centers in Tehran, Iran during the past 13 years were reviewed and extracted from an electronic database. Patients were divided into two groups based on the age at the time of diagnosis (≤40 and >40 years). The association of age with different clinicopathological features and its impact on disease-free survival were assessed. Study population comprised of 353(26.1%) patients who were 40 years old or younger and 1000(73.9%) who were older. Compared to older patients, younger participants had more commonly tumor size larger than 5 cm (P = 0.034), higher chance of lymph node metastasis (P = 0.036), and overexpression of HER-2 (P = 0.004). No significant differences were observed between the two groups regarding ER, PR, and LNR (lymph node ratio). Age was the only factor affecting patient's disease-free survival and younger patients had higher chance of local or distant metastases compared to older subjects (HR: 1.49, 95%CI: 1.02-2.17, P = 0.038). Based on the results of current study, it can be suggested that younger patients who are diagnosed with breast cancer tend to have larger tumor size, higher chance of lymph node metastasis and overexpression of HER-2 compared to patients older than 40 years. Age was the only significant factor that was associated with shorter disease-free survival.

The TP53 gene is the most important tumor suppressor gene in humans. The aim of our study was to determine the genotype frequency of three common TP53 polymorphisms (codon 72 BstUI and intron 6 MspI, as well as the intron 3) in a group of Iranian women with and without breast cancer. Paraffin-embedded specimens of 65 malignant breast cancer cases and 65 cases with benign breast lesions were investigated for the presence of three common TP53 polymorphisms by polymerase chain reaction. Samples were genotyped by polymerase chain reaction followed by variant specific restriction enzyme digestion. In our study, age grouping as >50 and ≤50 showed that the highest number of cancerous and non-cancerous patients was in the age group under 50; according to statistical tests, the difference was significant and recessive alleles of all three hot spots of TP53 had the highest frequency in the cancerous group. The majority of the cases with recessive alleles of all three hot spots of TP53 were in the age group ≤ 50. The difference between cancerous and noncancerous groups was statistically significant. Our results indicate that recessive alleles in three hot spots of TP53 gene might play a role in the breast cancer development, especially in women younger than 50 years.

It has been previously demonstrated that HER-2 (human epidermal growth Factor receptor 2) positive breast cancers are associated with an aggressive nature. Villin is an actin bundling protein that plays a key role in actin reorganization and cell remodeling during stress. In this study, we aimed to investigate the correlation of Villin gene expression with HER-2 in breast cancer patients. Samples of 42 patients with breast cancer, and 3 controls were collected. Expression of Villin and HER-2 genes were monitored with real-time PCR using pre-designed primers. Student T-test was used to compare the means between the groups. The mean age of the patients was 50±4.11years. Expression of the Villin gene was decreased in 28 samples (18 and 10 samples with negative and strongly HER-2 positive, respectively). Villin gene expression was increased in 14 samples (7, 2 and 5 samples with negative, weakly positive, and strongly HER-2 positive, respectively). The expression of Villin was significantly correlated with HER-2 positive status (P = 0.00057) We found that Villin gene expression is associated with HER-2 positivity and may be a predicting factor in aggressive breast cancer.

Lactating adenoma is a benign breast mass related to physiological changes during pregnancy and increased estrogen level. Fibroadenoma and breast cancer should be considered in the differential diagnosis of this lesion. The purpose of this study was to report cases of lactating adenoma in Breast Cancer Research Center (BCRC) and review the relevant literature. All patients with histological diagnosis of lactating adenoma between April 2010 and December 2015 were selected. Patients’ data were extracted from their medical records and follow-up of the patients were done through in-person examination or rarely by telephone call. A total of 22 patients with pathological diagnosis of lactating adenoma were enrolled. The mean age of patients was 27±4.6 years. Fourteen patients were in breast-feeding period and eight were pregnant at the time of diagnosis. The chief complaint was breast mass in 16 patients and pain 6 patients. The mean size of masses was 4.1 cm (1.8-8 cm). For 13 patients, core needle biopsy (CNB) and for 6 patients open biopsy were performed and for the other 3 patients vacuum-assisted biopsy were done. In 5 patients, excisional biopsy was done in the follow-up period that one of them proved to be medullary carcinoma and other cases were benign. Lactating adenoma commonly presents as a palpable mass during the breastfeeding period or the third trimester of pregnancy. The most common ultrasonographic appearance is a hypoechoic mass with regular borders. It usually regresses after cessation of breastfeeding, however in patients with mass enlargement during the follow-up, period pathologic evaluation of the lesion through core needle biopsy should be performed to rule out coexistent carcinoma.

There has been increasing trend towards surgical treatment of metastases across different cancer types, including breast cancer, in the recent decade. Single metastasis of breast cancer to sternum is a rare situation. We present a case of sternectomy for metastasis from breast cancer. A 58-year-old woman with a history of modified radical mastectomy for breast cancer 13 years earlier, presented with a mass over sternum. Diagnostic work up revealed a mass involving sternum and no evidence of systemic spread. She underwent resection of sternum and reconstruction of chest wall. Pathology revealed an invasive carcinoma that was hormone receptor positive on immunohistochemistry. Chemotherapy and radiotherapy were delivered after surgery and hormone therapy with Letrozole was initiated. She is disease free 37 months after surgery. Surgical treatment of solitary sternal metastasis of breast cancer is justifiable and may result in long term disease-free survival.