Background The clinicopathological characteristics of young breast cancer patients are characterized by strong aggressiveness and poor prognosis. However, there are few studies on the dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) features of young breast cancer.

Objective To investigate the MRI characteristics and clinicopathological features of young female breast cancer patients.

Methods A retrospective analysis was conducted on female patients with invasive breast cancer treated in the Department of General Surgery of the First Medical Center of Chinese PLA General Hospital from January 2019 to December 2020. The patients were divided into young breast cancer group (25-40 years old) and non-young breast cancer group (41-81 years old). The preoperative breast DCE-MRI images and clinical pathological features were analyzed for both groups.

Results Of the 333 cases, there were 63 cases in the young breast cancer group and 270 cases in the non-young breast cancer group. The young breast cancer group exhibited significant differences in several demographic and clinical variables compared to the non-young breast cancer group, including age, disease site, body mass index (BMI), menstrual status, and a history of hypertension (P＜0.05). Notably, the young breast cancer group displayed a higher incidence of non-mass enhancement (NME) on DCE-MRI (P=0.030), along with elevated levels of Ki-67 expression and a higher expression rate (both P＜0.05) when compared to the non-young breast cancer group. Furthermore, when compared to the young breast cancer mass enhancement subgroup, the young breast cancer non-mass enhancement subgroup had significantly lower expression levels of estrogen receptor (ER) (P=0.044), a lower high expression rate of progesterone receptor (PR) (P=0.047), and a lower rate of breast conserving surgery (P=0.011).

Conclusion Young breast cancer patients exhibit unique clinical pathological features, with NME more commonly showing in breast MRI, which may be related to more invasive pathological types and poorer prognosis.