Article Sidebar

Published
June 27, 2026
Download
PDF PDF
Statistic
Read Counter : 0

Main Article Content

Abstract

Adolescent and young adult (AYA) women, who are between the ages of 15 and 39, are known to have breast cancer that is both clinically and biologically aggressive. This retrospective, cross-sectional study analyzed clinical records of 499 female AYA breast cancer patients treated at Hiwa Cancer Hospital between 2010 and 2025. Data included demographic characteristics, tumour biology, Histopathology, molecular subtypes (Luminal A, Luminal B, HER2-enriched, and triple-negative), surgical approaches, and survival outcomes. Statistical analyses were conducted using SPSS v26, with significance set at p<0.05. In 499 AYA breast cancer patients, with a mean age of 34.4 years. The majority resided in urban areas (68.1%) and had abnormal BMI levels (79%). hormone receptor-positive/HER2-negative was most common (55.1%), followed by triple-negative (19%), hormone receptor-positive/HER2-positive (16.8%), and hormone receptor-negative/HER2-positive (9%). Triple-negative disease was more frequent than in older women and linked to grand multiparity, while nulliparity was associated with fewer aggressive cases. High-grade tumours were mainly triple-negative or HER2-positive, and low-grade tumours were mostly hormone receptor-positive/HER2-negative. Triple-negative cancers appeared more in node-negative cases, suggesting possible hematogenous spread. Survival was poorest in ages 25–29 (30%) and best in 35–39 (51%), underscoring the need for earlier detection and targeted therapies. Breast cancer among AYA women in Sulaimani City shows high rates of aggressive subtypes, abnormal BMI, and poor survival in the youngest patients. Patterns linking parity to triple-negative disease and high-grade tumours to HER2-positive or triple-negative profiles highlight the need for targeted approaches.

Keywords

AYA breast cancer Molecular subtypes Triple-negative HER2-positive

Article Details

License

Copyright (c) 2026 Chawan Faruq Qadir, Hazha Abdulla Mohammed Amin

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

References

  1. McVeigh UM, Tepper JW, McVeigh TP. A Review of Breast Cancer Risk Factors in Adolescents and Young Adults. Cancers (Basel). 2021;13(21). https://doi.org/10.3390/cancers13215552
  2. Oshi M, Yamada A, Gandhi S, Wu R, Sasamoto M, Yamamoto S, et al. Breast cancer in adolescents and young adults has a specific biology and poor patient outcomes compared with older patients. ESMO Open. 2024;9(11):103737. https://doi.org/10.1016/j.esmoop.2024.103737
  3. Toss A, Piombino C, Quarello P, Trama A, Mascarin M, Lambertini M, et al. Risk factors behind the increase of early-onset cancer in Italian adolescents and young adults: An investigation from the Italian AYA Working group. Eur J Cancer. 2024;212:115042. https://doi.org/10.1016/j.ejca.2024.115042
  4. Nathoo A, Brogly SB, Velez MP. Pregnancy Outcomes in Survivors of Adolescent and Young Adult Breast Cancer: A Population-Based Cohort Study. J Obstet Gynaecol Can. 2024;46(10):102638. https://doi.org/10.1016/j.jogc.2024.102638
  5. Futamura M, Yoshida K. Current status of AYA-generation breast cancer: trends worldwide and in Japan. Int J Clin Oncol. 2022;27(1):16-24. https://doi.org/10.1007/s10147-021-02087-4
  6. Elkum N, Aboussekhra A, Aboussekhra M, Aldalham H, Alshehri L, Alessy S, et al. Molecular Subtypes of Breast Cancer in Arab Women: Distribution and Prognostic Insights. J Epidemiol Glob Health. 2025;15(1):36. https://doi.org/10.1007/s44197-025-00376-z
  7. Carvalho E, Canberk S, Schmitt F, Vale N. Molecular Subtypes and Mechanisms of Breast Cancer: Precision Medicine Approaches for Targeted Therapies. Cancers (Basel). 2025;17(7). https://doi.org/10.3390/cancers17071102
  8. Mesa-Eguiagaray I, Wild SH, Williams LJ, Jin K, Bird SM, Brewster DH, et al. Breast cancer-specific survival by molecular subtype in different age groups of women in Scotland. Breast Cancer Res. 2025;27(1):59. https://doi.org/10.1186/s13058-025-02012-x
  9. Fabris VT, Spring L, Helguero LA. Editorial: Steroid hormone receptors and cell cycle in breast cancer. Front Endocrinol (Lausanne). 2023;14:1196523. https://doi.org/10.3389/fendo.2023.1196523
  10. Xu L, Xie Y, Gou Q, Cai R, Bao R, Huang Y, et al. HER2-targeted therapies for HER2-positive early-stage breast cancer: present and future. Front Pharmacol. 2024;15:1446414. https://doi.org/10.3389/fphar.2024.1446414
  11. Zhang M, Yuan L, Cui M, Chen J, Jia J, Zhao M, et al. Analysis the Burden of Breast Cancer Among Adolescents and Young Adults Using the Global Burden of Disease 2021. Ann Surg Oncol. 2025;32(3):2056-69. https://doi.org/10.1245/s10434-024-16648-0
  12. Abdulkareem AA, Ghalib HA, Rashaan MI. Factors causing delayed presentations of breast cancer among female patients in Sulaimani Governorate, Kurdistan region, Iraq. BMC Womens Health. 2023;23(1):612. https://doi.org/10.1186/s12905-023-02656-x
  13. Gomez-Banoy N, Ortiz EJ, Jiang CS, Dagher C, Sevilla C, Girshman J, et al. Body mass index and adiposity influence responses to immune checkpoint inhibition in endometrial cancer. J Clin Invest. 2024;134(17). https://doi.org/10.1172/JCI180516
  14. Yiallourou A, Pantavou K, Markozannes G, Pilavas A, Georgiou A, Hadjikou A, et al. Non-genetic factors and breast cancer: an umbrella review of meta-analyses. BMC Cancer. 2024;24(1):903. https://doi.org/10.1186/s12885-024-12641-8
  15. Lee F, Moore J, Markouli M, Ghusn W. The Oncogenic Burden of Obesity: Mechanistic Links Between Adiposity and Gastrointestinal Cancers-A Comprehensive Narrative Review. Biomedicines. 2025;13(7). https://doi.org/10.3390/biomedicines13071571
  16. Rahim HA, Hoseini R, Hoseini Z, Abbas EN, Kareem DA. Health-related factors of the Iraqi adult population during the 2020 COVID-19 pandemic: physical activity, eating behavior, quality of life, general health, and mood states cross-talk. BMC Public Health. 2023;23(1):1046. https://doi.org/10.1186/s12889-023-15898-z
  17. Kasgri KA, Abazari M, Badeleh SM, Badeleh KM, Peyman N. Comprehensive Review of Breast Cancer Consequences for the Patients and Their Coping Strategies: A Systematic Review. Cancer Control. 2024;31:10732748241249355. https://doi.org/10.1177/10732748241249355
  18. Cathcart-Rake EJ, Ruddy KJ, Bleyer A, Johnson RH. Breast Cancer in Adolescent and Young Adult Women Under the Age of 40 Years. JCO Oncol Pract. 2021;17(6):305-13. https://doi.org/10.1200/OP.20.00793
  19. Dogra AK, Prakash A, Gupta S, Gupta M. Prognostic Significance and Molecular Classification of Triple Negative Breast Cancer: A Systematic Review. Eur J Breast Health. 2025;21(2):101-14. https://doi.org/10.4274/ejbh.galenos.2025.2024-10-2
  20. Bhattacharya M, Liu B, Kurian AW, Stevens J, Enewold L, Penn DC. Receipt of guideline-concordant care and survival among young adult women with non-metastatic breast cancer. Breast Cancer Res Treat. 2025;210(2):347-54. https://doi.org/10.1007/s10549-024-07570-w
  21. Adrada BE, Moseley TW, Kapoor MM, Scoggins ME, Patel MM, Perez F, et al. Triple-Negative Breast Cancer: Histopathologic Features, Genomics, and Treatment. Radiographics. 2023;43(10):e230034. https://doi.org/10.1148/rg.230034
  22. Chitkara A, Mesa-Eguiagaray I, Wild SH, Hall PS, Cameron DA, Sims AH, et al. Reproductive history differs by molecular subtypes of breast cancer among women aged = 50 years in Scotland diagnosed 2009-2016: a cross-sectional study. Breast Cancer Res Treat. 2022;196(2):379-87. https://doi.org/10.1007/s10549-022-06721-1
  23. Kumar N, Ehsan S, Banerjee S, Fernandez Perez C, Lhuilier I, Neuner J, et al. The unique risk factor profile of triple-negative breast cancer: a comprehensive meta-analysis. J Natl Cancer Inst. 2024;116(8):1210-9. https://doi.org/10.1093/jnci/djae056
  24. Liu R, Xiao Z, Hu D, Luo H, Yin G, Feng Y, et al. Cancer-Specific Survival Outcome in Early-Stage Young Breast Cancer: Evidence From the SEER Database Analysis. Front Endocrinol (Lausanne). 2021;12:811878. https://doi.org/10.3389/fendo.2021.811878
  25. Zhu JW, Charkhchi P, Adekunte S, Akbari MR. What Is Known about Breast Cancer in Young Women? Cancers (Basel). 2023;15(6). https://doi.org/10.3390/cancers15061917

Similar Articles

You may also start an advanced similarity search for this article.