Clinicopathological characteristics and prognostic outcomes of young adult women (aged 18–30 years) with breast cancer in Ahmedabad, India: a single-centre, retrospective observational study

TL;DR

This study examines breast cancer in young Indian women, finding poor survival rates and highlighting the need for better treatment strategies.

Contribution

The study provides new clinicopathological and survival data for young adult breast cancer patients in Ahmedabad, India.

Findings

49.2% of cases were early breast cancers, while 23.8% were metastatic at diagnosis.

The 5-year overall survival rate was 48%, significantly lower than rates in high-income countries.

Clinical stage, grade, and luminal A status were significant predictors of survival.

Abstract

Breast cancer in young adult women is a rapidly growing group of cancer patients in India which needs to be addressed with urgency. Despite increasing global focus on breast cancer in young women, data from India remain scarce. Considering this gap, we undertook this study to analyse the clinicopathological characteristics and prognostic outcomes of young adult women (aged 18–30 years) with breast cancer in Ahmedabad, India.

This was a retrospective observational study of a prospectively maintained database of 201 patients with breast cancer (aged 18–30 years) treated in a high-volume tertiary centre in Ahmedabad, India, from January 2015 to December 2020. Patients were followed up until June 2023. The demographic parameters, clinicopathological characteristics and survival of all patients were studied. Statistical analyses were done using SPSS and DATAtab.

In this study 49.2% of cases were early breast cancers, 26.8% locally advanced, and 23.8% were metastatic. The proportion of aggressive cancers was higher with 38.8% hormone negative, 39.3% HER2-positive, 26.8% triple-negative and 50.8% grade 3. The median overall survival for all patients was 56 months (95% CI 28–84 months) and the 5-year overall survival was 48% (95% CI 40–56%). The multivariate analysis suggested that clinical stage, grade and luminal A status, significantly affected overall survival. The 5-year overall survival and disease-free survival of patients undergoing surgery were 65% (95% CI 57–74%) and 56% (95% CI 47–65%) respectively.

The 5-year overall survival rate of 48% among young adult women with breast cancer included in this study is poor compared to the 77% observed in high-income countries in the western parts of the world. Adoption of appropriate and aggressive treatment strategies may enhance the outcomes in this age group of women with breast cancer.

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