Young breast cancer patients in Germany can still be regarded as a special group. Although tumors are now more often detected before reaching the lymph nodes than 10 years ago, an even bigger percentage is triple negative. Operative treatment has improved to a less aggressive way. Still operative and medical treatments have to be chosen after very careful evaluation.

Our study shows that young breast cancer patients in Germany can be regarded as a special group. At the time of diagnosis the tumor has frequently reached a more advanced stage, and carcinomas are more aggressive. Operative and medical treatment will often be more aggressive.

Background: The purpose of the study was to characterize the treatment of young mothers with breast cancer in Germany and to investigate whether it followed applicable guidelines. Method: Retrospective data obtained between 2002 and 2011 for 1,053 mothers with children of < 12 years of age with adjuvantly treated loco-regional primary breast cancer were analyzed. Collected data included sociodemographic data, TNM stage, biology of tumor and therapies. Actually received therapies were compared to those suggested in guideline treatment plans. Results: The mean age of the patients was 39 years. 97% of the women with node positivity received an axillary dissection. Overall, 90% of the patients received chemotherapy with a guideline adherence range of 87-99% depending on clinical parameters. For radiation therapy, guideline adherence was high (range 82-100%). 95% of the patients with a hormone receptor-positive tumor received endocrine therapy; in 94%, tamoxifen therapy was performed in compliance with guidelines, whereas gonadotropin-releasing hormone (GnRH) agonist therapy complied with the guidelines in 52% of the cases. Conclusion: Guideline adherence in young mothers with breast cancer in Germany was high (with the exception of GnRH therapy), as comorbidity or the ambiguity of the therapeutic success does not need to be considered as much in this young, otherwise usually healthy, cohort compared to an age-heterogeneous group.

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Background and objective: The objective of the study is to evaluate how young breast cancer patients between 2002 and 2011 are treated adjuvantly and whether treatment adheres to the guidelines. The distinction between this cohort and a normally distributed cohort was verified. Materials and methods: The study evaluates the data from a total of 2500 patients who were treated adjuvantly in the period from 2002 until 2011 and participated in a resident mother-child program. Until now, the data of 1053 patients have been analyzed. In cohort I (date of diagnose: 2002 - 2006) 535 women were analyzed, in cohort II (date of diagnose: 2010-2011) 518. The data includes TNM-stage, the biology of tumor, therapies and their guideline-adherence. In addition the amount of participation in studies was evaluated. All data were compared to an age-heterogeneous cohort from the state of Schleswig-Holstein and the DMP- report of the state of North Rhine-Westphalia (“older group”). Results: The median age of the cohort I and II was 39 years. The median age of the age-heterogeneous groups was 59 years. 53% were diagnosed with stage pT1, 37% pT2, 7% pT3 or pT4. 49% of the patients in cohort I were pN0 (cohort II 58%), 31% pN1 (cohort II: 28%) and 20% (cohort II: 14%) had a more intense infestation of lymph nodes. The size of the tumors and the involvement of the lymph nodes were significant higher in the younger patients as in the older patients. 44% of the tumors showed G3, 34% were ER negative, 36% PR negative and 76% Her2 negative. 23% of the patients showed a triple negative carcinoma. The tumor biology was also worse in the younger patients than in the age-heterogeneous group. All in all in cohort I 47% of the patients underwent mastectomie (cohort II:37%, older patients: 29%). 59% of the patients in cohort I with stage pT1 underwent breast-conserving surgery (cohort II: 69%, older group: 82%). Overall 15% of the women in cohort I received mastectomy with subsequent reconstruction (cohort II: 17%, older patients: 7%). 25% of the patients in cohort I received sentinel node biopsy only (cohort II 48%), 90% of the young patients received chemotherapy (older patients 59%), overall 21% of them were treated within studies. 51% of the young patients with antiendocrine therapy received GnRH-analoga, in the age of 40 years or younger 41%. The examination with regard to the conformity with guidelines showed a high guideline adherence in the younger group. Conclusion: Young breast cancer patients provide a special challenge for the therapists because their prognosis is often worse because of a larger tumor and more metastatic lymph nodes as well as the worse tumor biology. They get a more aggressive therapy analogue to their worse situation. The therapies have a high guidelines adherence. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-10.

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