Abstract PS2-02-23: Clinicopathological profile and outcomes in young Indian patients with breast cancer - A single-center experience

Abstract Breast cancer has emerged as the most prevalent malignancy among women in India. Its epidemiological pattern in the Indian subcontinent differs significantly from that seen in Western countries. One of the most notable differences is the earlier age of onset in Indian women. In young women, breast cancer poses unique challenges due to its aggressive biological behaviour, concerns regarding fertility, and worse outcomes. This study aims to evaluate the clinicopathological characteristics, treatment approaches, and clinical outcomes of patients aged 40 years or younger, treated at a tertiary cancer center. We retrospectively analyzed the records of 102 breast cancer patients aged ≤40 years, presented between January 2023 and February 2025 at HCG Aastha cancer center Ahmedabad. Data were collected on demographics, family history, genetics, tumor histology, staging, receptor status, treatment modalities, and recurrence. The median age was 36 years (range 21 to 40 years). 4.9% of the patients were nulliparous, and 75.5% had no family history of malignancy. Genetic testing was done in 40 patients (39.2%). Among them, results were positive in 19 patients (18.6%), negative in 16 patients (15.7%), and showed variants of uncertain significance (VUS) in 5 patients (4.9%). Among these, BRCA mutations were predominant. In 51% of patients, genetic testing was advised but, they did not undergo the testing. Histology revealed Invasive Ductal Carcinoma (IDC) in 97 (95.1%) patients. Imaging for diagnosis primarily included bilateral mammography (79.4%). MRI and PET-CT were used in selected cases. Stage II was the most common stage at diagnosis, observed in 51 patients (50%), followed by Stage IV in 20 patients (19.6%). Hormone receptor positive, HER2neu negative was observed in 42 patients (41.1%), while both hormone receptor and HER2neu positivity were seen in 31 patients (30.4%). HER2neu positivity alone was noted in 9 patients (8.8%), triple-negative breast cancer (TNBC) was found in 15 patients (14.7%). Mammogram showed mainly dense breasts, well circumscribed and multicentric lesions. Surgical management was offered to the majority of patients who did not present with Stage IV disease. Among them, breast-conserving surgery (BCS) was performed in 34 patients (33.3%), while modified radical mastectomy (MRM) was performed in 33 patients (32.4%), indicating a nearly equal distribution between the two surgical approaches. Neoadjuvant chemotherapy (NACT) was given to 28 patients (27.4%), of whom 5 achieved a pathological complete response (pCR). Most patients remained on follow-up, with 10.8% experiencing disease recurrence. Among these, sites of recurrence included bone-only (1.9%), brain-only (1.9%), visceral-only (1.9%), and combined bone and visceral metastases (4.9%). Nearly half of the patients (47.1%) had no recurrence, while 40.2% were lost to follow-up. Recurrences were predominantly seen in those initially diagnosed with Stage II and III disease. Young women (</= 40 years) with breast cancer present with stage II-III disease, multicentric lesions that can be picked up on digital mammography most of the times. Most common subtype is hormone positive breast cancer, and 18% were deteced with germline mutations, BRCA being the most common. Recurrence was observed even in early-stage cases, underscoring the need for vigilant follow-up. Multidisciplinary care, including routine genetic counselling, remains essential. Future research should prioritize fertility preservation, psychosocial support, and long-term outcomes in this high-risk population. Citation Format: M. Shah, S. Patel, T. Shah, D. G. Vijay, S. Alurkar. Clinicopathological profile and outcomes in young Indian patients with breast cancer - A single-center experience [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS2-02-23.