Age-related biology of breast cancer - a potential for personalized therapeutic approach

Abstract

Introduction: Breast cancer is a leading cause of cancer-related mortality with 2.3 million new cases reported in 2020. Though more prevalent in the developed countries, mortality rates are also disproportionately elevated in Asia and Africa. Age-related variations in breast cancer with younger patients often exhibiting more aggressive tumor features, are well-established. However, there is limited research in Pakistan, especially in Peshawar.

Objectives: To explore how age impacts breast cancer biology by examining tumor characteristics, receptor status, histological subtype, and nodal involvement in female patients, thereby identifying patterns for personalized therapeutic strategies.

Materials & Methods: This retrospective cross-sectional study reviewed data from 113 histologically confirmed breast cancer patients aged 18-85 years who presented to the Breast Care Unit and Interventional Radiology Department of Rehman Medical Institute, Peshawar, between August 2019 and November 2023. Data collection included medical records and histopathological analyses, which focused on tumor characteristics, receptor status (ER, PR, HER-2), and Nottingham grading, with statistical analyses performed using SPSS version 27.

Results: Among the 113 patients, 98.2% were female, and 87.4% were from Khyber Pakhtunkhwa. Invasive ductal carcinoma was the predominant subtype, particularly among younger patients (100% vs. 81.7%). Younger patients had higher rates of triple-negative breast cancer (25% vs. 4.7%). Lymph node metastasis was in 63.5% of older patients, with ER+PR+ status in 43.5%.

Conclusion: Age significantly influenced breast cancer biology, with younger women showing more aggressive tumor characteristics, highlighting the need for early diagnosis and tailored treatments for younger patients in Peshawar.