Comparison between the Young and Elderly Diagnosed Patients of Carcinoma of the Breast

Ramsha Khan, Umar Javed, Atiq Ur Rehman
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Abstract

Breast cancer presents a significant health challenge in Pakistan, marked by high incidence rates and specific cultural and societal barriers to early detection and treatment. Objective: To compare diagnosed cases of CA breast in younger and older  patients in terms of mode of presentation, TNM stage at presentation, histological variety and hormonal status. Methods: In our prospective comparative study conducted at the Department of Surgery, Bahawal Victoria Hospital, Bahawalpur, we included a total of 220 breast cancer patients aged 20 years and above. Patients were stratified into two distinct age groups for comparison: younger patients (aged less than or equal to 35 years) and older patients (aged more than 35 years). Modes of presentation, histological types, and hormonal receptor statuses were compared between the both groups. Results: In a study of 220 breast cancer patients with a mean age of 42.97 years, younger patients (≤35 years) constituted 24%, while older patients (>35 years) made up 76%. The most common presentation was lump formation (78.18%), mainly in older patients. Ulceration was evenly distributed across age groups. Histologically, invasive ductal carcinoma Grade III was more frequent in older patients, whereas Ductal Carcinoma In Situ (DCIS) was exclusive to younger patients, underscoring distinct age-related disease patterns. Conclusions: Our study revealed significant age-related differences in breast cancer presentation among Pakistani patients. Older patients (>35 years) predominantly presented with lump formation, suggesting diagnostic delays, while all younger patients (≤35 years) had DCIS, indicating possible early detection or unique tumor biology. Additionally, older patients exhibited higher ER and PR positivity.  
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乳腺癌年轻患者与老年患者诊断结果的比较
在巴基斯坦,乳腺癌是一项重大的健康挑战,其特点是发病率高,而且在早期检测和治疗方面存在特定的文化和社会障碍。目的从发病方式、TNM 分期、组织学类型和荷尔蒙状态等方面,比较年轻和年长患者中已确诊的 CA 乳腺癌病例。研究方法在巴哈瓦尔布尔维多利亚医院外科进行的前瞻性比较研究中,我们共纳入了 220 名 20 岁及以上的乳腺癌患者。为了便于比较,我们将患者分为两个不同的年龄组:年轻患者(年龄小于或等于 35 岁)和年长患者(年龄大于 35 岁)。比较两组患者的发病方式、组织学类型和激素受体状态。研究结果在 220 名平均年龄为 42.97 岁的乳腺癌患者中,年轻患者(≤35 岁)占 24%,而年长患者(大于 35 岁)占 76%。最常见的表现是肿块形成(78.18%),主要发生在老年患者身上。溃疡在各年龄组中分布均匀。从组织学角度看,浸润性导管癌 III 级多见于老年患者,而导管原位癌(DCIS)则为年轻患者所独有,这突显了与年龄相关的独特疾病模式。结论:我们的研究显示,巴基斯坦患者的乳腺癌发病年龄存在明显差异。年龄较大的患者(大于 35 岁)主要表现为肿块形成,这表明诊断延误,而所有年轻患者(小于 35 岁)都有 DCIS,这表明可能存在早期发现或独特的肿瘤生物学特性。此外,年龄较大的患者ER和PR阳性率较高。
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