INTRA DUCTAL CARCINOMAS IN WOMEN YOUNGER THAN 35 YEARS

The incidence of intraductal carcinomas (IDC) of the breast is increas ing. However, few cases have been reported in young women. Based on a series of 13,168 women treated for breast cancer at the Institut Curie over a 12-year period, this article analyses the prevalence, clinical presentation prognosis and treatment of IDC in patients younger than 35 years. Of this series of 13,168 cancers, 882 occurred in women unde r the age of 35 years (6.7%). Sixteen of these cases (2%) were strictl y intraductal lesions and therefore constituted the study population. The frequency of IDC in women under the age of 35 years was identical to that of IDC in the general population of this study, The circumstan ces of discovery were: palpable tumour in seven cases (44%), mammograp hic discovery in Sour cases (25%), nipple discharge in five cases (31% ). Histological examination revealed a well-differentiated IDC in two cases, moderately differentiated in seven cases and poorly differentia ted in five cases (two cases not specified). Conservative treatment by lumpectomy and irradiation was performed in nine patients, and anothe r seven patients were treated by mastectomy and low axillary lymph nod e dissection. The mean follow-up was 83 months (range: 5 to 156 months ). A single patient has relapsed: an isolated invasive mammary recurre nce, 6 years after conservative treatment. This patient in now in comp lete remission after mastectomy. All patients are therefore alive, wit h no evidence of disease, at 83 months. In the group of women younger than 35, the frequency of IDC appeared to be identical to that observe d in the general population. Their prognosis after treatment is excell ent, and identical to that of IDC in older women. Conservative treatme nt is justified in localized forms, bur mastectomy with immediate reco nstruction must be performed in the presence of extensive disease.