[Breast cancer before 36 years of age]

Breast cancer in young women is a dreaded disease of bad prognosis, classically worse than for older women. A local study was undertaken in Lausanne to evaluate this notion. 94 cases aged less than 36 years were collected over 15 years, the incidence being 9 new cases per years per 100,000 under-36 women. 76% of the tumors were discovered accidentally by the patient, 24% by a physician during a routine breast examination. Delays from first symptom to histologic diagnosis were short, averaging 19 weeks. 80 mammographies were performed on the 94 cases, of whom 50 positives for a cancer, and 29 negative or doubtful. 22 of these negative 29 were reevaluated, 7 being positive for a tumor and 15 negative, showing either a benign mass or no lesion at all. 6 of the 7 positives were misdiagnosed in easy-to-read breasts, the false interpretation being chiefly caused by the young age of the patients. Pathologically, the rate of invasive ductal carcinoma was very high at 91.4%, which is the highest in the literature, and much higher than for older women in Lausanne (68%). Survival was 84% at two years, 63% at five years and 46% at 10 years, all deaths due to breast cancer. Those rates are better, globally and stage by stage, than for older women or than other reports on young women. We conclude that breast cancer in young women has a better prognosis than formerly thought.