Clinico-pathological Characteristics in Young Breast Cancer Patients: Single Centre Retrospective Study in a Low-Middle Income Country
Authors: 1. Ayasha Shiddika, 2. Qamruzzaman Chowdhury, 3. Salma Sultana, 4. Ferdous Ara Begum, 5. Sharmin Akter Rupa, 6. S M Khodeza Nahar Begum, 7. Mashud Parvez, 8. Md. Nurunnabi, 9. Md. Arifur Rahman
Institution: 1.Bangladesh Specialized Hospital (BSH), Dhaka, Bangladesh, 2. Akhaura Health Complex, Brahmanbaria, Bangladesh
Introduction
Breast cancer in younger patients can exhibit considerable clinicopathological heterogeneity. Characterising the presentation in a lower-middle-income setting may help inform timely diagnosis and individualised management. We assessed the initial clinicopathological characteristics of patients aged ≤45 years at a single centre in Bangladesh.
Methods
This retrospective cross-sectional study included 465 patients aged ≤45 years whose electronic medical records were available at Bangladesh Specialised Hospital during 2018–2024. Demographic characteristics, histology, tumour grade and stage, receptor phenotype, laterality, family history, and sites of disease involvement were analysed descriptively.
Results
The mean age was 37.7 ± 5.4 years; 302 patients were aged 35–45 years, 156 were aged 25–35 years, and seven were aged 15–25 years. Invasive ductal carcinoma was the predominant histology (82%), followed by ductal carcinoma in situ (14.7%). Grade II tumours were most frequent (260/465, 55.9%), followed by grade III tumours (182/465, 39.1%). Stage III was the commonest stage at presentation (187/465, 40.2%), followed by stage II (169/465, 36.3%), stage IV (56/465, 12.0%), and stage I (53/465, 11.4%). Receptor-defined phenotypes were ER/PR-positive, HER2-negative (177/465, 38.1%); triple-negative (153/465, 32.9%); triple-positive (102/465, 21.9%); and ER/PR-negative, HER2-positive (33/465, 7.1%). Left-sided, right-sided, and bilateral disease occurred in 250 (53.8%), 208 (44.7%), and seven (1.5%) patients, respectively. A positive family history was reported by 37 patients (8.0%). Regional lymph-node involvement was reported in 40.5%; listed distant sites included bone (4.5%), lung (3.0%), liver (3.0%), brain (1.0%), and skin (0.5%), while multiple sites were recorded in 5.0%.
Conclusion
More than half of patients aged ≤45 years presented with stage III–IV breast cancer, and grade II–III tumours were common. The substantial proportion of triple-negative disease and advanced-stage presentation underscore the importance of prompt assessment, early detection approaches, and individualised treatment pathways in this setting.