Molecular Subtypes and Prognostic Biomarkers of Breast Carcinoma in Different Age Groups: Findings from a Tertiary Care Hospital in Saudi Arabia

Sep 22, 2026

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Breast cancer causes substantial global mortality, and incidence is rising in Saudi Arabia, yet molecular subtype and prognostic biomarker evidence remains limited. A retrospective analysis compared clinicopathological and immunohistochemical features between patients aged ≤40 and those >40 using 300 Saudi female cases diagnosed from 2017–2022. Younger patients showed more aggressive disease, higher Ki-67 and lymph node spread, more TNBC, and worse short-term survival. Advanced stage and TNBC independently increased mortality risk.

LanguageEnglish

CategoryHealthcare

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Pages7

Reading Time18 min

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Abstract

Background and objectives

Methods

Results

Conclusion

Introduction

Molecular subtypes and biomarkers

Study rationale

Methods

| Original Article | | | --- | --- | | | | | Molecular Subtypes and Prognostic Biomarkers of Breast Carcinoma in Different Age Groups: Findings from a Tertiary Care Hospital in Saudi Arabia
Saima Aamir1,2, Nosheen Mahmood1,2, Nada A. Alhumrani2,3, Wateen A. Alshawi2,3, Layan A. Alyaeesh2,3, Aseel A. Alqarni2,3, Lubna A. Alagla2,3, Sadal G. Refae2,4
1 Department of Pathology, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 2 King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, 3College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, 4 Department of Oncology, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia | | | | | | Abstract
Background: Breast cancer is a leading cause of cancer‑related deaths globally, with a rising incidence in Saudi Arabia. However, limited studies from Saudi Arabia have reported the molecular subtypes and prognostic biomarkers of breast cancer.
Objectives: This study aimed at comparing the clinicopathological and immunohistochemical characteristics of breast cancer among two age groups from Saudi Arabia.
Methods: A retrospective study was conducted on Saudi female patients diagnosed with breast cancer between 2017 and 2022 at a tertiary care hospital in Riyadh. Patients were stratified into two age groups: aged ≤40 years and >40 years. Tumor size, grade, stage, and molecular subtypes were compared among these age groups.
Results: The study comprised 300 females with breast cancer (mean age: 53.2 ± 12.6 years) . Majority of patients (54.3%) were postmenopausal. The most common tumor type overall was invasive breast carcinoma of no special type (84%) . In patients aged ≤40 years, most patients had T4 tumor size (39%) and were at an advanced stage (69.2%) . Compared with those aged >40 years, patients aged ≤40 years had significantly higher Ki‑67 index (P < 0.001), lymph node spread (P = 0.009) and poor short‑term survival (P < 0.024) . Luminal A tumors were more common in the older age group, while significantly higher proportion of young patients had triple negative breast cancer (TNBC) (P = 0.035) . Cox regression analysis demonstrated advanced stage (hazard ratio [HR]: 12.4; P = 0.002) and TNBC (HR: 11.9; P = 0.002) as factors that raised the risk of mortality compared to early stage and luminal A type, respectively.
Conclusion: Breast cancer patients aged ≤40 years exhibited more aggressive clinicopathological features, including higher grade, advanced stage, triple negative receptor status, and poorer short‑term survival compared with patients aged >40 years.
Keywords: Breast carcinoma, estrogen receptor, human epidermal growth receptor 2, progesterone receptor, triple negative breast cancer, Saudi Arabia | | | Address for correspondence: Ms. Nada A. Alhumrani, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
E‑mail: [nadaalhumrani1@gmail.com](nadaalhumrani1@gmail.com)
Submitted: 21‑Apr‑2025 Revised: 22‑Oct‑2025 Accepted: 23‑Oct‑2025 Published: 19‑Jan‑2026 | | | Access this article online | | | --- | --- | | Quick Response Code: | Website:
[https://journals.lww.com/sjmm](https://journals.lww.com/sjmm) | | | | | | DOI:
10.4103/sjmms.sjmms_328_25 | 36 © 2026 Saudi Journal of Medicine & Medical Sciences | Published by Wolters Kluwer-Medknow Aamir, et al.: Prognostic biomarkers of breast carcinoma INTRODUCTION Breast carcinoma (BC) is one of the most frequently encountered malignancies across the globe.[1] According to the GLOBOCAN (Global Cancer Observatory) status report for 2020, female BC was the most often diagnosed tumor, accounting for more than 2.3 million new cases (11.7%), and was the most prevalent cause of cancer mortality.[2] A substantial rise in research publications related to BC has been witnessed over the last two decades in Saudi Arabia. [3] An alarming

FAQs

What was the main objective of the study?

The study aimed to compare clinicopathological and immunohistochemical characteristics of breast cancer between two age groups in Saudi Arabia and assess prognostic relevance of key biomarkers.

How were patients grouped in this retrospective study?

Patients were stratified into two age groups: aged ≤40 years and >40 years.

Which findings distinguished the ≤40 age group from the >40 group?

Patients aged ≤40 years had significantly higher Ki-67 index and lymph node spread, higher rates of triple negative breast cancer, and poorer short-term survival, with advanced-stage and higher-grade aggressive features.

Sep 22, 2026

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