The Association between Early-Onset Diagnosis and Clinical Outcomes in Triple-Negative Breast Cancer: A Systematic Review and Meta-Analysis

Abstract

Early-onset diagnosis, defined by age <40 years, has historically been associated with inferior outcomes in breast cancer. Recent evidence suggests that this association is modified by molecular subtype. We performed a systematic review and meta-analysis of the literature to synthesize evidence on the association between early-onset diagnosis and clinical outcomes in triple-negative breast cancer (TNBC). Studies comparing the risk of clinical outcomes in non-metastatic TNBC between early-onset patients and later-onset patients (≥40 years) were queried in Medline and EMBASE from inception to February 2023. Separate meta-analyses were performed for breast cancer specific survival (BCSS), overall survival (OS), and disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), distant recurrence-free survival (DRFS), and pathological complete response (pCR). In total, 7581 unique records were identified, and 36 studies satisfied inclusion criteria. The pooled risk of any recurrence was significantly greater in early-onset patients compared to later-onset patients. Better BCSS and OS were observed in early-onset patients relative to later-onset patients aged >60 years. The pooled odds of achieving pCR were significantly higher in early-onset patients. Future studies should evaluate the role of locoregional management of TNBC and the implementation of novel therapies such as PARP inhibitors in real-world settings, and whether they improve outcomes.

Molecular mechanism of oroxyli semen against triple-negative breast cancer verified by bioinformatics and in vitro experiments

“…[ 2 ] Currently, research on TNBC mainly focuses on the molecular biology mechanisms of the disease and targeted therapies. [ 3 ] Many studies use in vitro and in vivo models to evaluate the therapeutic effects of existing drugs and new compounds on TNBC. [ 4 ] In addition, an increasing number of studies are focused on screening potential therapeutic drugs from traditional Chinese medicine and natural products, and predicting and validating their mechanisms of action using bioinformatics methods.…”

Breast Cancer, a Global Health Crisis

“…Breast cancer arises from the accumulation of genetic and somatic mutations that lead to increased uncontrolled cell division and proliferation. Activating mutations in more than 30 cancer genes have been implicated in breast cancer, including AKT1, BRCA1, CDH1, GATA3, PIK3C, PTEN, RB1 and TP53 (Basmadjian et al, 2023). The risk of breast cancer is affected by many factors including age, family history, fertility history, hormonal exposure (use of combined estrogen and progestin hormone therapy after menopause), use of oral contraceptives, proliferative breast lesions, activity Physical, alcohol consumption, tobacco use, exposure to ionizing radiation, breast density, and environmental exposures possibly associated with breast cancer include dioxins and air pollution.…”