Mammographic and Sonographic Features of Breast Cancer in Women Before 30 Years of Age

Background: Breast cancer uncommonly occurs in young women, but, tends to be diagnosed at a later stage and have a poorer prognosis than in older women. Standard screening guidelines for this age group are not established and the radiologic features of breast cancer in young women are not fully studied yet, because of the low incidence. Objectives: To investigate the imaging findings for breast cancer in women aged 30 years or younger and to correlate them with clinicopathologic features and immunohistochemical subtypes. Methods: The study included 52 women with surgically confirmed breast cancer. The medical records of the patients were retrospectively reviewed and the mammographic and ultrasonographic findings were evaluated according to the fifth edition of the ACR BI-RADS lexicon. Results: Most of the tumors in this study were presented as a self-detected mass (42/52, 80.8%) and were of histologic grade III (31/43 invasive carcinoma, 72.1%) and the estrogen receptor-positive subtype (32/52, 61.5%). The most common mammographic finding was an irregular (19/24, 79.2%), indistinct (16/24, 66.7%), and hyperdense (20/24, 83.3%) mass. The ultrasonographic findings were of an irregular (32/47, 68.1%), indistinct (19/47, 40.4%), and hypoechoic/heterogeneous (40/47, 85.1%) mass with no posterior features (34/47, 72.3%). An oval/round-shaped mass on ultrasonography was also correlated with triple-negative cancer (p=0.011). Conclusion: On mammography and ultrasonography, breast cancer in young women usually presents as a mass with irregular shape and indistinct margin. Some radiologic findings could be used to predict the molecular phenotype of the tumor.