Clinicopathological and Hormone-Receptor Patterns in a Young Breast-Disease Cohort: A Retrospective Analysis of 399 Patients’ Records from 2023–2025 in Tripoli, Libya
Aug 2026· Libyan journal of medical research· 0 citations· 27 references
TL;DR
This unusually young cohort showed a high burden of grade II–III and locally advanced disease in Libya, but age was not significantly associated with grade, ER, PR, HER2, or disease extent, which limits generalizability.
Abstract
Background: Breast cancer (BC) is the most globally diagnosed malignancy among women. However, information on clinicopathological patterns in Libyan and North African women remains limited. This study examined age-related differences in histological diagnosis, disease extent, tumor grade, and hormone-receptor status in hospitalized BC women. Methods: A retrospective cross-sectional analysis was conducted on 399 patients from 2023–2025. All participants were aged 13–39 years. Age was summarized continuously and categorized as ≤29, 30–34, and 35–39 years. Diagnoses were harmonized into major histological groups. Estrogen receptor (ER), progesterone receptor (PR), and HER2 results were normalized as positive, negative, or unknown. Disease extent was operationally classified from TNM fields as early (T1–T2/N0–N1/M0), locally advanced (T3–T4 or N2–N3/M0), metastatic (M1), or unclassified. Associations were evaluated using Pearson’s chi-square tests, with two-sided P<0.05 considered statistically significant. Results :showed that the Mean age was 32.9±4.5 years, and the median age was 34 years (IQR 30–37). Invasive ductal carcinoma accounted for 342 records (85.7%), although benign and non-epithelial diagnoses were also present. Grade II and III tumours represented 51.1% and 40.6%, respectively. ER, PR, and HER2 positivity were counted in 44.1%, 37.6%, and 41.6% of cases, respectively. Basal-like, luminal A, luminal B, and HER2-enriched subtypes were recorded for 32.6%, 24.6%, 21.8%, and 20.3%, respectively. Locally advanced disease predominated (61.4%), while 17.0% were metastatic. Histological composition differed across age categories (P<0.001), but age was not significantly associated with grade, ER, PR, HER2, or disease extent. Conclusion: This unusually young cohort showed a high burden of grade II–III and locally advanced disease in Libya. However, diagnostic heterogeneity limits generalizability. Registry standardization, pathology verification, and population-based studies are required.
BACKGROUND
Stage at diagnosis, histologic grade, and molecular subtypes are established prognostic indicators for women with breast cancer (BC), but their impact on population-based survival estimates is poorly documented. This study assessed long-term BC survival trends according to these factors.
METHODS
We identified women aged <75 years diagnosed with stage I-IV invasive BC between 2004 and 2014 from the Friuli Venezia Giulia (North Eastern Italy) Cancer Registry (N = 10,476). Follow-up through 2023 was used to estimate overall and net survival (NS) according to combinations of prognostic factors.
RESULTS
The highest 10-year NS (10-NS) was observed in women with stage I HR+/HER2- subtype (98.8%), while it was 35.1% for stage III triple-negative (TN) subtype. Among women with stage IV BC, 10-NS was 18.9% for those HR-/HER2+, 11.5% for those HR+/HER2+, 8.3% for HR+/HER2-, and 6.7% for TN. For each stage, NS decreased with increasing grade. Comparing period of diagnosis (2004-2009 vs 2010-2014), 10-NS remained >90% for women with stage I BC, but improved for stage III and aggressive subtypes (HR-/HER2+ and TN). In women with stage III HR-/HER2+ BC, 10-NS increased from 48.6% to 87.9% (+39 percentage points), while when diagnosis was stage III TN BC it rose from 28.8% to 42.3.
CONCLUSION
Population-based estimates of long-term BC survival by combined stage, grade, and molecular subtype can inform the interpretation of evolving therapeutic strategies and improve risk stratification for patient follow-up.
Fabiola Giudici, D. Serraino, F. Puglisi et al.· The Oncologist· 0 citations
Background: Early-onset breast cancer (EOBC), defined as breast cancer in women under 45 years, is often associated with more aggressive biological behavior and poorer prognosis compared to older patients.
Objectives: (1) To evaluate the clinicopathological, immunohistochemical characteristics, and molecular subtypes of EOBC; (2) To investigate the associations between selected clinicopathological features and immunohistochemical profiles.
Materials and methods: A retrospective cross-sectional study was conducted on 72 patients with invasive breast cancer aged <45 years at Hue University of Medicine and Pharmacy Hospital from January 2023 to December 2025.
Results: The majority of tumors were >2 cm, with a high rate of lymph node metastasis (61.1%); most patients presented at stage II (54.2%). Invasive carcinoma of no special type (83.3%) and histological grade II (56.9%) predominated. Hormone receptor positivity was observed in 70.8% (ER) and 69.4% (PR) of cases, while a high Ki-67 index (≥20%) was present in 69.4%. Luminal B was the most common molecular subtype (38.0%). Significant associations were found between tumor size and clinical stage, as well as between histological grade and both hormone receptor status and molecular subtype (p < 0.05).
Conclusion: EOBC in this study demonstrates aggressive clinicopathological features and distinct molecular profiles, highlighting the critical role of tumor biology in disease behavior and its potential therapeutic implications.
Keywords: early-onset breast cancer, immunohistochemistry, molecular subtype.
Phương Thảo Tiên Nguyễn, T. Trần, Anh Hung Tran et al.· Tạp chí Y Dược Huế· 0 citations
AR expression was present in 42% of TNBC cases and showed no significant association with clinicopathological parameters and showed no significant association with clinicopathological parameters.
K. S, Johnraj Suresh M, Narayana Vadivoo R· Asian Journal of Medical Sci...· 0 citations
Summary Background Estrogen receptor (ER) low (1–9%) breast cancer (BC) often behaves like triple-negative BC, while ERhigh (≥60%) disease has a more favorable prognosis. However, tumors with ER expressing 10–59% represent a poorly defined patient population. In this nationwide cohort study, we aimed to describe real-world patient characteristics, treatment patterns and survival across the entire ER spectrum in Human Epidermal growth factor Receptor 2 (HER2)-negative BC. Methods We conducted a population-based cohort study of all women diagnosed with HER2-negative BC in Sweden (2007–2023), based on prospectively collected data. Tumors were stratified into five ER subgroups: ER0% (ERzero), ER1–9% (ERlow), ER10–29% (ERmild), ER30–59% (ERmod), and ER60–100% (ERhigh). We evaluated overall survival (OS) by ER subgroups and treatment (chemotherapy [CT] and endocrine therapy [ET]) using Kaplan–Meier analysis and multivariable Cox regression. Findings We included 75,211 patients. Compared to the ERhigh subgroup, both the ERmild (adjusted HR [aHR] = 1.59, 95% confidence interval [CI]: 1.31–1.93) and ERmod (aHR = 1.31, 95% CI: 1.17–1.47) subgroups had significantly worse survival (both adjusted P [aP] < 0.001). Notably, ERmild patients had survival outcomes and molecular characteristics similar to those of ERlow and ERzero patients. Patients with ERmild (aHR = 0.46, 95% CI: 0.23–0.94, aP = 0.033) and ERmod (aHR = 0.60, 95% CI: 0.42–0.85, aP = 0.0046) tumors, CT + ET was associated with a lower risk of death than ETonly. Interpretation Our findings highlight the importance of assessment of ER-low, mild and moderate tumors (1–59%). Reporting ER as a percentage can provide additional biological insight in clinical decision-making. Funding This study received no external funding.
Qiao Yang, C. Boyaci, I. Zerdes et al.· The Lancet Regional Health -...· 0 citations
Triple-negative breast cancer (TNBC) is characterized by aggressive biological behavior and poor prognosis. While multimodal treatment is standard, it is frequently withheld from older adults. We evaluated age-related gaps in diagnosis, treatment, and survival, testing whether disparities in clinical management drive worse outcomes in older adults. This 10-year retrospective cohort study (2010–2019) included 289 TNBC patients stratified into three age groups (≤ 45, 46–69 and ≥ 70 years). Clinicopathological features, treatment patterns, adherence to the ESMO-defined standard of care (SOC), and 5-year survival were analyzed. TNBC incidence (10.8%) remained consistent across age groups (
p =
0.374). Patients aged ≥ 70 years presented with larger tumors (median: 27 mm;
p =
0.003) and received less intensive diagnostic workups (
p <
0.001). SOC adherence was significantly lower in older adults (50.9% vs. 85.9% in those ≤ 45 years;
p <
0.001). SOC nonadherence increased the risk for both overall mortality (OM) (HR: 3.47) and breast cancer-specific mortality (BCSM) (sHR: 2.88) (
p <
0.001). Failure to achieve pathologic complete response (pCR) tripled mortality risk (OM HR: 3.74,
p
= 0.016; BCSM sHR: 3.54,
p
= 0.018). Older women had lower survival rates than did those aged 46–69 years for both 5-year overall (56.0% vs. 83.0%;
p <
0.001) and breast cancer-specific survival (63.0% vs. 85.0%;
p =
0.006). The poorer prognosis in older adults with TNBC is significantly associated with clinical management disparities and low SOC adherence, while histopathological markers of tumor aggressiveness remain highly prevalent across the age spectrum. Daily practice must transition from chronological age-based decisions toward biological fitness to overcome ageism, avoid undertreatment, and ensure personalized therapeutic decision-making.
Dinis Galhardo, B. Peleteiro, Fernando Osório· Aging Clinical and Experimen...· 0 citations
To examine the associations between reproductive factors — parity, lactation duration, and menopausal age — and tumour characteristics, molecular subtype, and PC-RISK-5 prognostic scores in women with breast cancer from a tertiary centre in Kerala, India.
This retrospective cohort study included 221 women with invasive breast carcinoma diagnosed between January 2015 and June 2016 at a tertiary centre in Kerala, India. Molecular subtyping followed the St Gallen 2013 framework (Luminal A defined as Ki-67 <20%; HER2 3+ only). The PC-RISK-5 score assigned one point each for age >60 years, Ki-67 >30%, histological grade ≥II, lymph node positivity, and HER2 (IHC 2+/3+). Patients were stratified into three age bands (≤39, 40–65, >65 years). Associations were assessed using chi-squared, Kruskal–Wallis, and Mann–Whitney tests. Overall survival was analysed using Kaplan–Meier estimates with log-rank comparison. A two-sided
p
< 0.05 was considered statistically significant.
Among 221 women (mean age 55.7 years), invasive ductal carcinoma predominated (93.7%). Later menopausal age was associated with higher PC-RISK-5 scores (mean 2.27, 2.86, and 3.00 across <42, 42–50, and >50 years;
p =
0.028) and with greater nodal positivity (19%, 46%, and 57%;
p =
0.041). PC-RISK-5 scores differed significantly across molecular subtypes (
p =
0.0003), being highest in HER2-driven tumours. Lactation duration showed a non-significant trend toward lower triple-negative proportion with longer duration (25.9% to 14.9%;
p =
0.32). Parity, age at first childbirth, and reproductive factors overall showed no significant association with molecular subtype, grade, or survival.
In this Kerala cohort, most reproductive factors were not significantly associated with tumour biology or outcome. Later menopausal age was the notable exception, associated with higher prognostic risk and nodal involvement, consistent with prolonged oestrogen exposure. PC-RISK-5 scores varied with molecular subtype, although this partly reflects shared components.
Parvathy Chandra Kollamparambil, D. Ramakrishnan· South Asian Journal of Cance...· 0 citations
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