A Comparative Study of Breast Cancer of Korean Women according to Age in Radiological, Pathological, and Clinical Findings

Young Rahn Lee, B. Seo, K. B. Chung, K. Cho, J. Lee, Young Hen Lee, Hyung Joon Noh, Seung Hwa Lee, O. Woo, Bo-Kyung Je, Kyoung Rae Kim, Jung Hyuk Kim, J. Bae, Insun Kim
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Abstract

Purpose: The incidence of breast cancer is continuously increasing in Korea, and the age of the initially detected breast cancer is younger than western people. The purpose of this study was to compare radiological, pathological, and clinical findings of breast cancers according to age and then contribute to the basis of screening program of breast cancer. Methods: Retrospectively, the 325 patients who had pathologically confirmed breast cancer were included in this study. The patients were classified into 6 groups according to age, 20∼29, 30∼39, 40∼49, 50∼59, 60∼69, and more than 70 years. We evaluated the radiological findings of 325 cases of mammography and 144 cases of breast ultrasonography, classified as four types; mass, microcalcification, others, and non-detected lesion, and then analyzed radiological findings according to age. We evaluated pathological and clinical findings according to age and compared with radiological findings. We used Mantel-Haenszel's χ test and trend test for comparison according to age. Results: The incidence of breast cancer was 61 cases (19%) in 30∼39 years, 122 (38%) in 40∼49 years, 92 (28%) in 50∼59 years. Most of breast cancer was invasive ductal carcinoma, 258 (79%) and in situ carcinoma was 32 (10%). Most of in situ carcinoma was detected in 20∼59 years, 31/32 (97%). Mammography showed mass in 237 (73%), microcalcification in 45 (14%), other finding in 13 (4%), and non-detected lesion in 30 (9%). Twenty-one (47%) of 45 cases with microcalcification were in situ carcinoma and most of in situ carcinoma was presented as microcalcification on mammography, 21/32 (66%). In twenty-eight of 30 cases (93%) with non-detected lesion on mammography, breast cancer was detected on ultrasonography. In terms of clinical findings, there was no symptom in 12/32 (38%) with in situ carcinoma and 57/258 (22%) with invasive ductal carcinoma. Conclusion: The incidence of breast cancer is abruptly increasing from 4th decades and there is no significant difference in radiological and clinical findings according to age. But, most of in situ carcinoma was detected in 20∼59 years and presented as microcalcification on mammography. Thus, Screening mammography should be considered from 4th decades. (Journal of Korean Breast Cancer Society 2002;5:91-101)
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韩国不同年龄女性乳腺癌放射学、病理和临床表现的比较研究
目的:韩国乳腺癌发病率持续上升,且乳腺癌初检年龄比西方人群年轻。本研究的目的是比较不同年龄乳腺癌的放射学、病理和临床表现,为乳腺癌筛查计划提供依据。方法:回顾性分析325例经病理证实的乳腺癌患者。患者按年龄分为20 ~ 29岁、30 ~ 39岁、40 ~ 49岁、50 ~ 59岁、60 ~ 69岁、70岁以上6组。我们对325例乳腺x光检查和144例乳腺超声检查的影像学表现进行了评价,将其分为4种类型;肿块、微钙化、其他及未检测到的病变,然后根据年龄分析影像学表现。我们根据年龄评估病理和临床表现,并与影像学表现进行比较。采用Mantel-Haenszel χ检验和趋势检验进行年龄间比较。结果:30 ~ 39岁的乳腺癌发病率为61例(19%),40 ~ 49岁的发病率为122例(38%),50 ~ 59岁的发病率为92例(28%)。大多数乳腺癌为浸润性导管癌,258例(79%),原位癌32例(10%)。大多数原位癌在20 ~ 59岁被发现,31/32(97%)。乳房x光检查显示肿块237例(73%),微钙化45例(14%),其他发现13例(4%),未发现病变30例(9%)。45例微钙化患者中有21例(47%)为原位癌,多数原位癌在x线摄影上表现为微钙化,21/32例(66%)。30例乳腺x光检查未发现病变的患者中,超声检查发现乳腺癌28例(93%)。临床表现方面,原位癌12/32(38%)无症状,浸润性导管癌57/258(22%)无症状。结论:40岁以后乳腺癌的发病率呈急剧上升趋势,不同年龄段的乳腺癌放射学和临床表现无明显差异。但是,大多数原位癌在20 ~ 59岁时被发现,并在乳房x线摄影上表现为微钙化。因此,筛查性乳房x光检查应从40年代开始考虑。(韩国乳腺癌学会杂志2002;5:91-101)
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