Luminal B subtype: A key factor for the worse prognosis of young breast cancer patients in China

Abstract

BackgroundThe prognoses of young breast cancer patients are poor. The purpose of this study is to evaluate the different characteristics and prognoses among different subtypes of young breast cancer patients.MethodsThe study included 1360 patients <40 years-old (y) and 3110 patients 40-50y with operable breast cancer in Shanghai Cancer Center, Fudan University. The characteristics, overall survival (OS) and disease-free survival (DFS) were compared.ResultsThe median follow-up was 54.1 months. More grade III tumors and more lymph-vascular invasions (P < 0.01) were presented in <40y group when compared with 40-50y group. More patients <40y presented with Luminal B (25.3% vs. 17.5%, P < 0.01) and triple negative (16.7% vs. 13.4%, P < 0.05) breast cancer while fewer had Luminal A tumor (48.5% vs. 59.2%, P < 0.01). Younger patients with tumors of both Luminal A and Luminal B types were at increased risk for worse DFS (P = 0.03, HR = 1.69, 95% CI = 1.05-2.72; P < 0.01, HR = 3.61, 95% CI = 2.50-5.22) when compared with the older patients. Patients <40y with Luminal B tumor had a two point five fold higher risk of death compared with older counterparts (P < 0.01, HR = 2.54, 95% CI = 1.35-4.79), however, a worse overall survival rate was not observed in the younger women with Luminal A breast cancer (P > 0.05). In multivariate analysis, Luminal B subtype was also a strong predictor of disease relapse (HR = 1.09, 95% CI = 1.01 to 1.19, P < 0.01) in younger patients with Luminal subtype tumors.ConclusionCharacteristics of breast cancer suggested a more aggressive biology in Chinese patients with breast cancer diagnosed at young age. Luminal B subtype may have a negative effect on the prognosis of young patients in China which should be validated further.

Molecular Subtypes and Prognosis in Young Mexican Women With Breast Cancer

“…The observed survival pattern is very similar to that found in a large retrospective Chinese study in which young patients with Luminal B tumors exhibited a significantly worse OS. 29 On multivariate analysis, and in contrast with what was seen for DFS, age was not a factor significantly related with OS. This might be explained by the fact that the difference in DFS rates was driven not only by Luminal B tumors, but also by Luminal A and HER2+ disease, which have previously shown to have higher relapse rates in young women.…”

“…This might be explained by the fact that the difference in DFS rates was driven not only by Luminal B tumors, but also by Luminal A and HER2+ disease, which have previously shown to have higher relapse rates in young women. 28,29 However, while both Luminal A and HER2+ tumors have a higher risk of recurrence, the lack of effect on survival can be attributed to the excellent response to treatment and the prolonged survival of these two subtypes in the metastatic setting. 31 The worse survival found in Luminal B disease may be related to adherence to hormonal treatment, which has been shown to be poor in young, non-white women.…”

Integrative molecular profiling identifies a novel cluster of estrogen receptor‐positive breast cancer in very young women

“…Prognosis was predicted to be worse for patients in groups B and C, characterized by chromosome instability, than in luminal A patients, a finding that could be consistent with the poor prognosis of young patients. 57 Group C demonstrated highly activated immune scores that could be applicable for immune therapy.…”

Survival Analysis in Young–Age Breast Cancer and Related Clinicopathologic Factors at dr Cipto Mangunkusumo General Hospital 2008–2015

“…The overall 5-year survival rate in this study reach up to 64%, which is much lower than those reported. 15,16 The logic explanation to these findings is the high proportions of advanced stage population presented at RSCM. Almost 60% of population presented in a locally advanced and metastatic stage; both were associated with poor survival rate (85% and 38%, respectively) compared to those of the earlier stage (96%).…”