Abstract P1-14-01: Incidence, Clinicopathological Features and Treatment Outcomes Of Young Breast Cancer Patients: A Cohort Analysis From a High-Volume Tertiary Cancer Center in The United Arab Emirates
Authors: Al-Awadhi Aydah , Hourani Mohammed , Hussein Mawada , Alkindi Fatima , Wahba Lina , AlAgha Abla , Shoqeir Alaa , Yousif Ali , AlShebli Mouza , Trad Diaeddine , Masih Asif , Azribi Fathi , Luiten Ernest J. , Al-Shamsi Humaid , Toffaha Khaled 
Published: March 2023

Introduction: Breast cancer (BC) in women age 40 or younger represents approximately 7% of all BC cases. Studies have reported that BC in younger women is more likely to have adverse tumor characteristics and outcomes when compared to elder women. Despite the fact that BC in the Middle East seems to occur at a younger age, data on tumor characteristics in these patients are scarce, especially in the United Arab Emirates.

Objective: This study was conducted to investigate the incidence, clinicopathological characteristics, treatment modalities, and outcomes of young BC patients at a major cancer center in the UAE, Tawam Hospital. This will provide a better insight in local features and enables comparison of UAE data with other parts of the world.

Method: Data of 911 BC patients age ≤ 40 years treated at Tawam Hospital between 2000 and 2020 were analyzed. Information was obtained from the prospective Tawam Hospital Cancer Registry database and analyzed using (Python 3.9.7).

Result: A total of 911 patients were included in this study. Median follow up time 34 months (0.3 - 1404). Patients ≤ 40 years of age comprised 24% (911/3782) of all BC cases diagnosed between 2000-2020. The clinical and pathological characteristics of these patients are provided in table 1. Of the total population, 625 (68.6%) patients were diagnosed based on palpable breast mass. 67 (7.3%) had pregnancy-related BC, and 346 (38%) had hereditary genetics testing conducted. Of those, 38 (11%) had pathogenic mutation (13 BRCA1, 16 BRCA2, 4 TP53, 2 PalbB2, 1 ATM, 1 APC, 1 NBN) and 59 (17%) had mutations with variants of unknown significance. Of patients with early-stage disease (N=764), 14 (2%) had excisional biopsy, 314 (41%) had a lumpectomy and 474 (62%) had a mastectomy, 257 (34%) had sentinel lymph node sampling, 439 (57%) had axillary lymph node dissection, 621(81%) had adjuvant radiation therapy, 727 (95%) had adjuvant/neoadjuvant systemic chemotherapy +/- anti-HER2/neu therapy. Of those who received neoadjuvant systemic therapy (N=341/727), 123 (36%) achieved pathologic complete remission. Of those with HR+ status early BC (N=487/764), 455 (93%) received adjuvant hormonal therapy (180 (40%) ovarian suppression, 391 (86%) tamoxifen, 39 (8.5%) aromatase inhibitor). Of all early BC patients, 180 (24%) developed recurrent disease (initial site: 45 (25%) locoregional recurrence, 83 (46%) visceral metastases, 66 (37%) bone metastases, 22 (12%) brain metastases, and 1 other sites). Kaplan Meier with log rank analysis and cox-proportional hazard models to be presented in the meeting.

Conclusion: The findings of this study are in accordance with previous studies on young BC patients. On initial presentation, patients had higher-grade tumors, a significant proportion with HER2/neu positive disease, larger tumor size, and nodal involvement. This study will help clinicians, researchers, and decision-makers better understand the unmet needs for young breast cancer patients in the UAE.

Table 1: Clinical and Pathological Characteristics of young BC patient ≤ 40 (N=911)

Citation Format: Aydah Al-Awadhi, Mohammed Hourani, Mawada Hussein, Fatima Alkindi, Lina Wahba, Abla AlAgha, Alaa Shoqeir, Ali Yousif, Mouza AlShebli, Diaeddine Trad, Asif Masih, Fathi Azribi, Ernest J. Luiten, Humaid Al-Shamsi, Khaled Toffaha. Incidence, Clinicopathological Features and Treatment Outcomes Of Young Breast Cancer Patients: A Cohort Analysis From a High-Volume Tertiary Cancer Center in The United Arab Emirates [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-14-01.