Long-term age-dependent failure pattern after breast-conserving therapy or mastectomy among Danish lymph-node-negative breast cancer patients

Laurberg, Tinne; Lyngholm, Christina D; Christiansen, Peer; Alsner, Jan; Overgaard, Jens

doi:10.1016/j.radonc.2016.05.006

Cited by 18 publications

(18 citation statements)

References 51 publications

(83 reference statements)

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“…The original study cohort (N ¼ 813) was designed with balanced five-year age groups, based on register data from the DBCG and described in detail previously [7]. The original DBCG89a cohort comprised patients considered as having a low risk of recurrence according to the guidelines at the time.…”

Section: Study Populationmentioning

confidence: 99%

“…As previously described [7], patients were followed with clinical examination biannually for five years and then annually for up to 10 years. Complete 20-year follow-up data (including consecutive registration of all breast cancer events for every patient) were obtained from the Danish Civil Registration System, the National Pathology Register and general practitioners (GP), and by reviewing the patients' medical records.…”

Section: Study Populationmentioning

confidence: 99%

“…In the absence of LRR, the observation time was censored at the earliest of the following competing events: CC, DM, other malignant disease or death. Follow-up was continued until the return date of the letter from the GP, the reading date of the electronic medical records or death, as described previously [7]. In the absence of breast cancer death, CC and other causes of death were recorded as competing events.…”

Section: Endpoints and Statistical Analysismentioning

confidence: 99%

“…The v 2 -test was used to compare the distribution of baseline characteristics, intrinsic subtypes, and breast cancer failures among groups. Age was dichotomized using 45 years as the cut-point, based on the pattern of failure described previously [7]. The study population was divided into younger patients ( 45 years) and older patients (>45 years).…”

Section: Endpoints and Statistical Analysismentioning

confidence: 99%

“…In a recent Danish study of low-risk breast cancer patients enrolled in the Danish Breast Cancer Group (DBCG) 89a-protocol [7], we found that local recurrence was associated with distant metastasis (DM) among younger patients ( 45 years). Moreover, younger patients who received breast-conserving therapy (BCT) had a higher mortality than younger patients who had mastectomy in the DBCG89a cohort treated according to the guidelines at the time.…”

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confidence: 99%

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Impact of age, intrinsic subtype and local treatment on long-term local-regional recurrence and breast cancer mortality among low-risk breast cancer patients

et al. 2016

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Section: Study Populationmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Endpoints and Statistical Analysismentioning

confidence: 99%

Section: Endpoints and Statistical Analysismentioning

confidence: 99%

mentioning

confidence: 99%

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Impact of age, intrinsic subtype and local treatment on long-term local-regional recurrence and breast cancer mortality among low-risk breast cancer patients

et al. 2016

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Breast-conserving surgeryversusmastectomy in young women with breast cancer in Asian settings

et al. 2018

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BackgroundMastectomy rates among women with early breast cancer in Asia have traditionally been high. This study assessed trends in the surgical management of young women with early‐stage breast cancer in Asian settings. Survival in women treated with breast‐conserving surgery (BCS; lumpectomy with adjuvant radiotherapy) and those undergoing mastectomy was compared.MethodsYoung women (aged less than 50 years) newly diagnosed with stage I or II (T1–2 N0–1 M0) breast cancer in four hospitals in Malaysia, Singapore and Hong Kong in 1990–2012 were included. Overall survival (OS) was compared for patients treated by BCS and those who had a mastectomy. Propensity score analysis was used to account for differences in demographic, tumour and treatment characteristics between the groups.ResultsSome 63·5 per cent of 3536 women underwent mastectomy. Over a 15‐year period, only a modest increase in rates of BCS was observed. Although BCS was significantly associated with favourable prognostic features, OS was not significantly different for BCS and mastectomy; the 5‐year OS rate was 94·9 (95 per cent c.i. 93·5 to 96·3) and 92·9 (91·7 to 94·1) per cent respectively. Inferences remained unchanged following propensity score analysis (hazard ratio for BCS versus mastectomy: 0·81, 95 per cent c.i. 0·64 to 1·03).ConclusionThe prevalence of young women with breast cancer treated by mastectomy remains high in Asian countries. Patients treated with BCS appear to survive as well as those undergoing mastectomy.

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Risk of first recurrence after treatment in a population-based cohort of young women with breast cancer

Schaffar,

Benhamou,

Chappuis

et al. 2024

Breast Cancer Res Treat

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Purpose Breast cancer (BC) in women under 45 is rare yet often aggressive. We aim to analyze loco-regional recurrences (LR), distant recurrences (DR), second breast cancers, and mortality in young BC patients. Methods We enrolled 776 women with non-metastatic BC ≤45 years diagnosed from 1970 to 2012. Variables included age, family history, tumor stage/grade, and treatment. We used multivariate Cox regression and competing risk models. Results Among the participants, 37.0% were diagnosed before the age of 40. Most had stage I or II, grade II, ER- and PR-positive, HER2-negative tumors. Over a median follow-up of 8.7 years, 10.1% experienced LR, 13.7% developed DR, and 10.8% died, primarily due to BC. The majority of recurrences occurred within the first five years. Older age (>40) significantly reduced the risk of LR and DR. Advanced disease stage, certain surgical strategies, and positive margins increased DR risk. In the cohort diagnosed between 2001 and 2012, recent diagnosis, triple-negative cancer, and hormonal therapy were associated with reduced LR risk. Breast-conserving surgery appeared to offer protective effects against DR. Conclusion This study highlights that BC in young women carries a significant risk of early recurrence, with age, tumor characteristics, and treatment modalities influencing outcomes. The findings emphasize the need for tailored treatment strategies for young BC patients, focusing on surgical precision and aggressive adjuvant therapy for high-risk cases. This research contributes valuable insights into managing BC in younger patients, aiding in improving long-term outcomes.

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Long-term age-dependent failure pattern after breast-conserving therapy or mastectomy among Danish lymph-node-negative breast cancer patients

Abstract: BCT patients with no adjuvant systemic treatment developed LR throughout 20-year period and faced higher LR risk than mastectomy patients. LR was associated with DM among younger patients, and younger BCT patients had higher mortality than younger mastectomy patients.

Cited by 18 publications

References 51 publications

Impact of age, intrinsic subtype and local treatment on long-term local-regional recurrence and breast cancer mortality among low-risk breast cancer patients

Impact of age, intrinsic subtype and local treatment on long-term local-regional recurrence and breast cancer mortality among low-risk breast cancer patients

Breast-conserving surgeryversusmastectomy in young women with breast cancer in Asian settings

Risk of first recurrence after treatment in a population-based cohort of young women with breast cancer

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