Research Article Breast Cancer by Age at Diagnosis in the Gharbiah, Egypt, Population-Based Registry Compared to the United States Surveillance, Epidemiology, and End Results Program, 2004–2008 Jennifer A. Schlichting, 1 Amr S. Soliman, 2 Catherine Schairer, 3 Joe B. Harford, 4 Ahmed Hablas, 5 Mohamed Ramadan, 5 Ibrahim Seifeldin, 5 and Sofia D. Merajver 1,6 1 Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA 2 Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE 68198, USA 3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA 4 Center for Global Health, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA 5 Tanta Cancer Center, Tanta, Gharbiah 31111, Egypt 6 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA Correspondence should be addressed to Amr S. Soliman; amr.soliman@unmc.edu Received 27 May 2015; Accepted 30 July 2015 Academic Editor: Peijun Liu Copyright © 2015 Jennifer A. Schlichting et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. Although breast cancers (BCs) in young women ofen display more aggressive features, younger women are generally not screened for early detection. It is important to understand the characteristics of young onset breast cancer to increase awareness in this population. Tis analysis includes all ages, with emphasis placed on younger onset BC in Egypt as compared to the United States. Methods. BC cases in the Gharbiah cancer registry (GCR), Egypt, were compared to those in the Surveillance, Epidemiology, and End Results (SEER) database. Tis analysis included 3,819 cases from the GCR and 273,019 from SEER diagnosed 2004–2008. Results. GCR cases were diagnosed at later stages, with <5% diagnosed at Stage I and 12% diagnosed at Stage IV. 48% of all SEER cases were diagnosed at Stage I, dropping to 30% among those ≤40. Signifcant diferences in age, tumor grade, hormone receptor status, histology, and stage exist between GCR and SEER BCs. Afer adjustment, GCR cases were nearly 45 times more likely to be diagnosed at stage III and 16 times more likely to be diagnosed at stage IV than SEER cases. Conclusions. Future research should examine ways to increase literacy about early detection and prompt therapy in young cases. 1. Introduction Breast cancer (BC) in young women in the United States (US) is a relatively rare occurrence [1]. However, BC is the leading cause of cancer death in adult women less than 60 years of age in high-income countries [2]. Furthermore, numerous studies have reported that BCs in young women tend to display more aggressive features, such as larger tumor size, poor diferentiation, positive lymph nodes, high prolifera- tion rates, higher incidence of Human Epidermal Growth Factor Receptor 2 (HER2/neu) overexpression, abnormal p53 expression, DNA aneuploidy, estrogen receptor/progesterone receptor negativity, and more tumors of the basal-like histo- logic subtype [3–10]. Studies dating back over thirty years have reported a high proportion of “rapidly progressing breast cancer” (RPBC) with infammatory BC (IBC) characteristics in the North African country of Tunisia [11–15]. Findings from these Tunisian studies have spurred interest in further BC research Hindawi Publishing Corporation BioMed Research International Volume 2015, Article ID 381574, 9 pages http://dx.doi.org/10.1155/2015/381574