STRATIFICATION OF PALPABLE AND NONPALPABLE BREAST-CANCER BY METHOD OFDETECTION AND AGE

Background: Methods used to diagnose breast cancer in women under the age of 50 years are somewhat controversial. To determine the relations hip between type and stage of breast cancer, clinical presentation, an d age, we reviewed breast cancer diagnosed at our institution during a recent 3-year period. Methods: Records from 589 consecutive excisiona l biopsies and 372 needle placement biopsies performed over a 3-year p eriod were reviewed. Carcinomas were staged according to the TNM syste m and results compared using chi(2). Results: Breast carcinoma was dia gnosed in 118 women during the study period, 33% in patients under 50 years of age. Breast cancer diagnosed by mammography in all age groups was more likely to be noninvasive than that diagnosed by physical exa mination (p < 0.05). The few invasive cancers diagnosed by mammography in women under age 50 were lower in stage than those diagnosed by phy sical examination, although not by a statistically significant amount (p = 0.125). Breast cancer diagnosed by mammography in women 50 years and older was significantly lower in stage than that diagnosed by phys ical examination (p < 0.05). Conclusions: Invasive carcinoma detected as a nonpalpable lesion by mammography was earlier in stage than invas ive carcinoma detected by physical examination, including in women und er 50 years of age, although the number of invasive cancers detected i n younger women was quite small. The role of mammography in this young er age group remains to be defined.