Evaluation of recurrence patterns and survival in modern series of young women with breast cancer

Abstract

The data on oncologic outcomes in young women with breast cancer (BC) are dated as it relates to recurrences and mortality. Our goal was to assess these outcomes in a modern series of young women with BC. A retrospective chart review identified women ≤40 years old with stage I-III BC diagnosed from 2006 to 2013 at our institution. Demographics, tumor biology, type of operation, recurrence, and survival were analyzed. Overall, 322 women were identified. Most had ER+(70%) infiltrating ductal tumors (88%) with low stage (42% T1; 41% T2; 56% N0). Follow-up was 4.2 years with 5.6% local-regional recurrence (LRR), 15.2% metastatic recurrence (MR), and 8% mortality. There was no survival difference based on demographics, tumor biology, or type of operation. T3 tumors (P < .001) and node positivity (P < .001) were associated with worse disease-free survival. In this modern series of young women with BC, stage rather than tumor biology or surgical choice has more effect on recurrence-free survival. MR was more common than LRR, with most MR occurring within the first 2 years after surgery.

Validation of the 8th edition of the American Joint Committee on Cancer Pathological Prognostic Staging for young breast cancer patients

“…It does appear that conflicting results regarding the role of tumor biology, including tumor grade, ER, PR, and HER2 status in young breast cancer. Several prior studies showed similar or inferior outcomes related to ER positive status in young patients [21][22][23][24][25][26][27], while others demonstrated superior outcomes associated with ER positive status [28,29]. It was hypothesized that young patients have lower compliance with hormonal therapy [34].…”

“…Several recent studies have validated the prognostic effect of the new staging system in breast cancer [18][19][20]. However, the prognostic impact of tumor biologic factors incorporated in the current staging system of young patients remains controversial [21][22][23][24][25][26][27][28][29][30][31][32][33]. Several prior studies showed similar or inferior outcomes related to ER-positive status in young women [21][22][23][24][25][26][27], while others indicated better survival rates associated with ER-positive status [28,29].…”

Incidence and characteristics of breast cancer in patients 40 years of age or younger: a study of a tertiary center in Saudi Arabia

“…This necessitates early detection and prompt treatment of these young patients, as the delay in management may have a huge impact on their survival. 11 Also, this can be of interest in upcoming studies. To gain a better understanding of the behavior of breast cancer in young women, we analyzed the pathological and biological features of the disease.…”