Presentation of breast cancer (BC) diagnosed at or before 30 years of age: Implications for screening women at hereditary risk.

1526 Background: Women with BRCA1/2 or P53 mutations are recommended BC surveillance with mammogram (MMG) and MRI beginning at age 25. The incremental yield of MMG in this age group is not clear. Methods: The MSK Breast Disease Management Team database was queried to identify women diagnosed with BC =< 30 years. Medical records were abstracted to determine clinical characteristics and mode of presentation. Results: Between 1/99 and 7/08, 345 women with BC diagnosed =< 30 years (median 28, 11-30) were evaluated at our institution before definitive treatment. 269 (78%) were white, 23 (6.6%) black, and 13 (3.8%) Hispanic. Most presented with a palpable mass (324/345, 94%) or nipple discharge (9/345, 2.6%). 6 patients (1.8%) were asymptomatic. Median tumor size was 21.5 mm (1-150). Of those with complete information, 147/301 (48.8%) had axillary nodal metastases, 132/345 (44.1%) were HR+ (ER and/or PR+) and HER2-, 76 (25.4%) were TNBC, 33/345 (11%) were HR-/HER2+, and 58/345 (19.4%) were HR+/HER2+. Diagnostic...