Epidemiological changes in premenopausal patients with breast cancer: a two-decade retrospective study

Introduction

In the past decades there appears to have been a decrease in the mean age of presentation of breast cancer in premenopausal patients from developed countries, coinciding with an increase in maternal age at first delivery. The main objectives of this study were to determine the epidemiological features of premenopausal patients with primary breast carcinoma diagnosed in our unit for the past 20 years, and to evaluate any significant changes observed during this period.

Methods

Between January 1988 and December 2008, 162 premenopausal patients with primary breast carcinoma were evaluated at our center. A total of 85 patients came prior to January 2000, and 77 patients between January 2000 and December 2008. We used statistical parametrical tests (Student t test and chi-square test) to compare mean age at the time of diagnosis, maternal age at first delivery, parity, lapse time between last delivery and diagnosis of cancer, staging, histological tumor grade, and whether the diagnosis was made based on on-demand screening mammography or based on clinical findings.

Results

No significant differences were found in female age at the time of diagnosis (43.1 ± 5.2 years vs 43.6 ± 4.6 years) There were significant differences in maternal age at first pregnancy (27.2 ± 4.6 years vs 31.5 ± 4.4 years), lapse time between last delivery and cancer (11.9 ± 6.3 years vs 9.3 ± 6.1 years), parity (54% vs 45% in multiparous patients), staging (47% vs 56% stage 0 or I), histological grade (26% vs 42% grade III tumors) and diagnosis (43% vs 57% by screening).

Conclusion

The results of this study indicate that female age at the time of diagnosis has remained constant for the past two decades while maternal age for first delivery has increased. The lapse time until cancer diagnosis decreased from the last delivery. In the past decade, on-demand screening programs have helped us diagnose more cases that were at lower stages even if they were of higher histological grade.