Assessment of imaging, and histopathological findings, and their correlation with clinical outcomes in breast cancer patients under the age of 40

Objective: This retrospective, single-center study aimed to evaluate the radiologic and histopathologic features of breast cancer in patients younger than 40 years, to examine the correlation between these features, and to investigate their impact on clinical outcomes. Materials and Methods: Data from 149 breast cancer patients under 40 years of age were analyzed, including MRI images, pathology reports, and follow-up information obtained from our hospital system. Patients who were not followed up in our hospital were contacted by telephone. Results: A significant correlation was observed between edema and cancer molecular subtype (p=0.038), with edema independently predicting axillary lymph node involvement (p=0.011). Age, presence of edema, mass size, and axillary node positivity were identified as independent risk factors for overall survival (p=0.046, p=0.045, p=0.007, p=0.043, respectively). The presence of edema and axillary node positivity were also independent risk factors for recurrence (p=0.003 and p<0.001, respectively). Conclusion: Edema on breast MRI is less common in luminal A cancers compared to other molecular subtypes. When the determinants of overall and disease-free survival were analyzed, survival rates were found to be worse in patients with edema on breast MRI. In addition, age, tumor size and axillary lymph node involvement were found to be independent risk factors for overall survival. Edema may be used in combination with traditional prognostic factors such as tumor size and axillary lymph node involvement to predict disease prognosis. Keeping in mind that the disease may have a worse prognosis in patients with edema detected on breast MRI and modifying the treatment protocol accordingly, if necessary, may improve survival rates. Keywords: Breast, MRI, young age, survival, recurrence, edema, axillary lymph nodes.