Epidemioclinical aspects of breast cancer in women under 35 years at the oncology and palliative care department of Soavinandriana Hospital

Tafitarilova Dorland Ranjandriarison; Hanitra Rova Antsafinoana Andriamamuhaja; Ranaivo Livasoa Ralay; Patty Navoly; Vonjy Harilala Raparson; Nomeharisoa Rodrigue Emile Hasiniatsy

doi:10.18203/2320-6012.ijrms20253137

Authors

Tafitarilova Dorland Ranjandriarison Department of Obstetrics and Gynecology, Soavinandriana Hospital Center, Faculty of Medicine Antananarivo, Madagascar
Hanitra Rova Antsafinoana Andriamamuhaja Department of Medical Oncology and Palliative Care Unit, Soavinandriana Hospital, Antananarivo, Madagascar
Ranaivo Livasoa Ralay Department of Medical Oncology and Palliative Care Unit, Soavinandriana Hospital, Antananarivo, Madagascar
Patty Navoly Department of Medical Oncology and Palliative Care Unit, Soavinandriana Hospital, Antananarivo, Madagascar
Vonjy Harilala Raparson Doctor of Medicine, Faculty of Medicine, University of Antananarivo, Antananarivo, Madagascar
Nomeharisoa Rodrigue Emile Hasiniatsy Department of Medical Oncology and Palliative Care Unit, Soavinandriana Hospital, Antananarivo, Madagascar

DOI:

https://doi.org/10.18203/2320-6012.ijrms20253137

Keywords:

Breast cancer, Young women, Epidemiology, Histopathology, Low-resource settings

Abstract

Background: Breast cancer is rare among women under 35 years, but its incidence is increasing, particularly in low-resource settings. Young patients often present with aggressive disease and delayed diagnosis. This study aimed to describe the epidemioclinical features of breast cancer in this population.

Methods: A retrospective descriptive study was conducted from January 2014 to September 2024 at the oncology and palliative care department of Soavinandriana Hospital, Madagascar. 38 women under 35 years old with histologically confirmed breast cancer were included.

Results: Among 2,087 breast cancer cases, 38 (1.82%) involved women under 35. The mean age was 30.7 years. Most patients were pauciparous (50%), had breastfed (73.7%), were non-smokers (81.6%), and had no family history of breast or ovarian cancer (76.3%). The upper outer quadrant was the most common tumor site (34.2%). Invasive carcinoma of no special type was predominant (78.9%). Grade II and III tumors accounted for 65.8%. More than 50% of patients were diagnosed at an advanced stage (IIB or higher). Immunohistochemical and staging data were frequently incomplete due to limited diagnostic resources.

Conclusions: Breast cancer in young Malagasy women is uncommon but presents aggressively and at advanced stages, underscoring the need for early detection strategies. Improved diagnostic access and tailored screening programs are essential.

Metrics

Metrics Loading ...

References

World Health Organization. Breast cancer. Available at: https://www.who.int/news-room/fact-sheets/detail/breast-cancer. Accessed on 21 July 2025.

International Agency for Research on Cancer. Global cancer observatory: Cancer today. Available at: https://gco.iarc.fr/today. Accessed on 21 July 2025.

Breast Cancer Research Foundation. Breast cancer in young women. Available at: https://www.bcrf.org. Accessed 21 July 2025.

Rasolo J, Randriamanantena A, Raveloson I. Epidemiological aspects of breast cancer among young women in Madagascar. Madagascar Med J. 2021;26(2):33-9.

Andrianarivelo N, Raveloson I. Late-stage diagnosis of breast cancer in Madagascar: a study of 300 cases. Madagascar Med J. 2020;25(1):12-8.

Moussa AM, Ali AM, Raharimalala M. Barriers to breast cancer screening among young women in Antananarivo, Madagascar: a qualitative study. Afr Health Sci.

Silva IR, Lopes-Costa PV, dos Santos AR, da Silva BB, Maranhão NM. Breast cancer in young women: Epidemiology, molecular biology, and risk factors. J Cancer Res Clin Oncol. 2016;142(1):1-12.

Nwankwo EO, Anyaehie UB, Nwafor CC. Breast cancer in sub-Saharan Africa: the Nigerian experience. J Glob Oncol. 2015;1(2):103–107.

Lee AH, Pinder SE, Elston CW. Lifestyle factors and breast cancer risk in young women: A meta-analysis. Int J Cancer. 2019;144(10):2471-9.

Azim Jr HA, Santoro L, Russell-Edu W, Pentheroudakis G, Pavlidis N, Peccatori FA. Prognosis of pregnancy-associated breast cancer: a meta-analysis of 30 studies. Cancer Treat Rev. 2012;38(7):834-42. DOI: https://doi.org/10.1016/j.ctrv.2012.06.004

Assi HA, Khoury KE, Dbouk H, Khalil LE, Mouhieddine TH, El Saghir NS. Epidemiology and prognosis of breast cancer in young women. J Thorac Dis. 2013;5(Suppl 1):S2-8.

Anderson WF, Rosenberg PS, Prat A, Perou CM, Sherman ME. How many etiological subtypes of breast cancer: two, three, four, or more? J Nat Cancer Inst. 2014;106(8):dju165. DOI: https://doi.org/10.1093/jnci/dju165

Diallo F, Traoré B, Cissé B, et al. Clinical and histopathological characteristics of breast cancer in young women at the Joliot-Curie Institute in Dakar (Senegal). Afr Cancers. 2020;2(3):45-51.

Mqoqi N, Kellett P, Sitas F, Jula M. Incidence of Histologically Diagnosed Cancer in South Africa, 1998-1999. National Cancer Registry; 2004.

Ben Fatma L, et al. Characteristics of breast cancer among young women in Tunisia. Tunis Med. 2021;99(3):220-7.

Anders CK, Johnson R, Litton J, Phillips M, Bleyer A. Breast cancer before age 40 years. Semin Oncol. 2009;36(3):237-49. DOI: https://doi.org/10.1053/j.seminoncol.2009.03.001

Rhiem K, Engel C, Graeser M, et al. Familial breast cancer and early diagnosis in young women: Results from the German consortium for hereditary breast and ovarian cancer. Cancer Epidemiol. 2012;36(4):e261-7.

Ibrahim NA, Ahamed DS, Hussien RM. Breast cancer in young women: a clinicopathological study. J Cancer Res Ther. 2015;11(2):259-63.

El Fakir S, et al. Conditions for the discovery of breast cancer in Morocco. Rev Epidemiol Public Health. 2018;66(2):101-7. DOI: https://doi.org/10.1016/j.respe.2018.03.110

Dilhuydy JM, et al. Breast cancer screening in young women: situation in France. Bull Cancer. 2016;103(6):509-15.

Ndom P, Bell EM, Doh AS, et al. A pilot survey of breast cancer awareness and breast self-examination in a sub-Saharan African setting: Cameroon. Pan Afr Med J. 2015;21:85.

Houssami N, Ciatto S, et al. Breast symptoms and cancer diagnosis in women under 40. Breast. 2017;31:84–89. DOI: https://doi.org/10.1016/j.breast.2017.09.003

Abebe R, Gebremariam MB, et al. Clinical presentation and diagnostic delay of breast cancer patients in Ethiopia. BMC Womens Health. 2020;20:70.

Silva IR, Lopes-Costa PV, dos Santos AR, da Silva BB, Maranhão NM. Breast cancer in young women: Epidemiology, molecular biology, and risk factors. J Cancer Res Clin Oncol. 2016;142(1):1-12.

Lee AH, Pinder SE, Elston CW. Lifestyle factors and breast cancer risk in young women: a meta-analysis. Int J Cancer. 2019;144(10):2471-9.

Duffy MJ, et al. Role of tumor markers in breast cancer: CA 15-3 and CEA. Clin Chem. 2010;56(11):1451–1462.

Molina R, Barak V, van Dalen A, Duffy MJ, Einarsson R, Gion M, et al. Tumor markers in breast cancer- European Group on Tumor Markers recommendations. Tumor Biol. 2005;26(6):281-93. DOI: https://doi.org/10.1159/000089260

Berg WA, et al. Diagnostic imaging of symptomatic women under 40 years of age with a focus on breast cancer. Radiology. 2004;231(2):367-77.

Barr RG, Zhang Z, et al. Probably benign breast lesions in young women: imaging-pathologic concordance. Am J Roentgenol. 2015;205(1):221-7.

Rakha EA, El-Sayed ME, et al. Breast cancer histologic grading: past, present and future. Arch Pathol Lab Med. 2010;134(7):1066-74.

Bourhafour M, et al. Particularities of breast cancer among young women in Morocco. Pan Afr Med J. 2015;20:249.

Sandhu GS, et al. Histopathological profile of breast carcinomas in young women: A tertiary care study. Indian J Pathol Microbiol. 2021;64(1):43-8.

Cancello G, Maisonneuve P, Rotmensz N, Viale G, Mastropasqua MG, Pruneri G, et al. Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (<35 years) with operable breast cancer. Ann Oncol. 2010;21(10):1974-81. DOI: https://doi.org/10.1093/annonc/mdq072

Odetola TD, et al. Immunohistochemical subtypes of breast cancer in Nigerian women: A 10-year retrospective review. Niger Med J. 2018;59(2):59-64.

Thangjam T, et al. Profile of breast cancer molecular subtypes and its impact on survival among women in India. Asian Pac J Cancer Prev. 2020;21(8):2375–2381.

Nwankwo EO, Anyaehie UB, Nwafor CC. Breast cancer in sub-Saharan Africa: The Nigerian experience. J Glob Oncol. 2015;1(2):103-7.

Gupta P, Deb R, Singh S. Epidemiology of breast cancer in young women in India. Cancer Res Treat. 2017;49(4):253-62.

Alshahrani ZS, Alshahrani MS, Alzahrani HA. Breast cancer in young women in low- and middle-income countries: a systematic review. BMC Public Health. 2021;21(1):698.