Breast cancer in very young women (<30 years): Correlation of imaging features with clinicopathological features and immunohistochemical subtypes

Abstract Objective Early diagnosis of breast cancer in very young women ( Material and Methods A total of 50 surgically confirmed breast cancers were included in our retrospective study. The medical records were reviewed and the radiological features were analyzed according to the new 5th edition of the ACR BI-RADS lexicon. Results The breast cancers in our study population most commonly presented as a self-detected mass (74%), T2-3 stage (58%), histological grade III (52.3%) and ER-positive (80%) subtype. The most common finding was an irregular (87.5%) hyperdense (66.7%) mass with indistinct margins (50%) on mammography and an irregular (75.6%) indistinct (57.8%) hypoechoic/heterogeneous (77.8%) mass without a posterior acoustic feature (60%) on ultrasonography. MRI revealed an irregular shape (63.3%), irregular margins (43.3%), and heterogeneous enhancement (60%) with washout kinetics (69.4%). Mammographically, microcalcifications were correlated with the HER2-enriched type, and mass-type lesions were correlated with triple-negative cancer ( p  = 0.04). An oval/round mass on ultrasound ( p  = 0.005), rim enhancement ( p  = 0.004) and intralesional T2 high signal intensity ( p  = 0.04) on MRI were associated with the triple-negative type. Conclusions On all imaging modalities, breast cancer in very young women usually presented as an irregular mass, and certain radiological features could be used for predicting the specific tumor type.