Abstract

Background. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. From 2000–2002, patients (N > 3500) were enrolled at 77 Italian hospitals. Women aged ≤50 years (N = 1013) were stratified into age groups (≤35, 36–40, 41–45, and 46–50 years). The relationship between age and patient characteristics, cancer presentation, and treatment was analyzed. Results. Younger women more frequently had tumors with ER/PgR-negative(χ 2 = 7.07; P = .008), HER2 amplification (χ 2 = 5.76; P = .01), and high (≥10%) Ki67 labelling index (χ 2 = 9.53; P = .002). Positive nodal status, large tumors, and elevated Ki67 all associated with the choice for chemotherapy followed by endocrine therapy in hormone receptor-positive patients (P < .0001). At univariate analysis, ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ≤40, P < .0001, resp.). At multivariate analysis, after adjustment for significant clinical and pathological factors, age remains a significant prognostic variable (HR = 0.93, P = .0021). Conclusion. This cohort study suggests that age per sè is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial.

Highlights

  • The incidence of breast cancer increases with age but is not infrequent in women younger than age 40 years; approximately 2% of women are younger than 35 years when breast cancer is diagnosed [1]

  • This paper presents data concerning the biological characteristics of breast cancer and adjuvant treatment strategies in women ≤50 years, stratified according to age group

  • A total of 3532 breast cancer patients were enrolled by 71 Italian centers

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Summary

Introduction

The incidence of breast cancer increases with age but is not infrequent in women younger than age 40 years; approximately 2% of women are younger than 35 years when breast cancer is diagnosed [1]. The principal aim of the NORA (National Oncological Research observatory on Adjuvant therapy in breast cancer) study was to describe treatment strategies and reasons for their selection in a population of breast cancer patients radically treated after surgery. This paper presents data concerning the biological characteristics of breast cancer and adjuvant treatment strategies in women ≤50 years, stratified according to age group. The present paper described the biological characteristics and clinical behavior of young women in the cohort NORA study Patients and Methods. ER-ve status, chemotherapy and age resulted as the only statistically significant variables (HR = 2.02, P = .004, and >40 versus ≤40, P < .0001, resp.). This cohort study suggests that age per se is an important prognostic factor. The restricted role of early diagnosis and the aggressive behavior of cancer in this population make necessary the application of targeted medical strategies crucial

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