Younger women with breast carcinoma have a poorer prognosis than older women

Chung, Maureen A.; Chang, Helena R.; Bland, Kirby I.; Wanebo, Harold J.

doi:10.1002/(sici)1097-0142(19960101)77:1<97::aid-cncr16>3.3.co;2-t

Cited by 82 publications

(104 citation statements)

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“…Age has been found to be a prognostic factor in some studies [1,6,10], but not in all [22]. In our study, age 35 years or younger was an unfavourable prognostic factor in the PA group only.…”

Section: Discussioncontrasting

confidence: 62%

Pregnancy and breast cancer: a population-based study

et al. 2003

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The incidence of pregnancy-associated breast cancer, i.e. during pregnancy and lactation, and of pregnancy subsequent to a breast-cancer diagnosis will increase as more women choose childbearing at a later age. Few larger series are published on pregnancy-associated breast cancer. In a population-based study, we evaluated the outcome and prognostic factors in 173 breast-cancer patients. One hundred and twenty-two patients had pregnancy-associated breast cancer (20 coincident with pregnancy and 102 during lactation) and 51 patients had pregnancy subsequent to breast cancer. The median follow-up time was 151 months. Histopathological parameters and immunoreactivity for oestrogen and progesterone receptors c-erbB-2 and c-erbB-4 were studied. All three groups had tumours with high histological grade, low frequency of hormone receptors and high expression of c-erbB-2. The pregnancy and lactation groups were near identical with regard to all histopathological parameters and outcome. In the two pregnancy-associated breast-cancer groups, tumours were significantly larger, with more extensive lymph-node involvement. For node-negative tumours the respective 5- and 10-year survival rates were 62% and 50% in the pregnancy group and 60% and 50% in the lactation group. For node-positive tumours, respective 5- and 10-year survival rates were 50% and 34% in the pregnancy group and 50% and 33% in the lactation group. In the subsequent group, overall survival was high in both node-negative and -positive groups, with 5- and 10-year survival rates of 80% and 73% and 86% and 76%, respectively. Tumour size, lymph-node status, histological grade, progesterone receptor, oestrogen receptor and c-erbB-2 were significant prognostic factors in the pregnancy-associated breast-cancer patients.

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Section: Discussioncontrasting

confidence: 62%

Pregnancy and breast cancer: a population-based study

et al. 2003

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“…In this context, it is of interest that young breast cancer patients have a more aggressive phenotype and poorer prognosis than older women (Adami et al 1986;Chung et al 1996). Young lung cancer patients also have a poorer prognosis than older patients [8].…”

Section: Introductionmentioning

confidence: 99%

Gastric cancer in very young adults: apropos four patients and a review of the literature

Kath

Fiehler

Schneider

et al. 2000

Journal of Cancer Research and Clinical Oncology

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Whether gastric cancer in young adults differs from gastric cancer in older patients has been a controversial issue. It has long been suspected that young patients with gastric cancer have different biological features with a more aggressive course of disease and a poorer prognosis than older patients. This, however, has not been firmly substantiated. We report on the clinical course of four patients (three female and one male) with locally advanced (n = 1) or metastasized (n = 3) non-resectable gastric cancer diagnosed under the age of 29 years (23, 25, 27, 28 years). Prior to diagnosis, all three women had recently been pregnant (1-22 months). Diagnosis was endoscopically biopsy-proven and staging work-up was performed by primary explorative surgery (n = 1), laparoscopy and explorative surgery (n = 1) or CAT scan and ultrasound (n = 2). The delay between initial symptoms and diagnosis was 8-22 weeks (median, 10 weeks). The histology was signet-ring cell (n = 2) or undifferentiated (n = 2) gastric cancer. All patients had the diffuse type of gastric cancer according to Lauren. Patients were treated with the FLAP polychemotherapy regimen consisting of leucovorin, 5-fluorouracil, doxorubicin and cisplatinum, as previously reported. The best response after chemotherapy was partial in two patients. Two patients showed progressive disease. Secondary surgery was performed in three responding patients (one of them responded only locally). One patient achieved no evidence of disease after complete tumor resection (R0). In two patients surgery was palliative (R2/exploration). Three patients died 6, 4 and 8 months after diagnosis. One patient is still alive. In our series, very young adults with gastric cancer had adverse clinical and pathological features. In accordance with other reports, we observed a predominance of female patients and a possible association with recent pregnancies. Though the delay between the first symptoms and diagnosis in our patients was no different from that reported for older patients, special emphasis should be given to prompt referral and diagnostic investigations, ensuring the diagnosis of gastric cancer early in the course of disease.

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“…[12][13][14][15] Several investigators have shown that early onset breast cancer is associated with more aggressive tumor features, including larger tumor size, presence of positive lymph nodes, absence of steroid receptors and a high S-phase fraction. 16 -18 In further support of the hypothesis that breast cancer in younger women may be of a different nature, including biological origin, some investigators have found young age to be an independent predictor of adverse prognosis.…”

mentioning

confidence: 99%