Abstract
IntroductionYoung age at the time of diagnosis of breast cancer is an independent factor of poor prognosis. In many treatment guidelines, the recommendation is to treat young patients with adjuvant chemotherapy regardless of tumor characteristics. However, limited data on prognostic factors are available for young breast cancer patients. The purpose of this study was to determine the prognostic value of established clinical and pathological prognostic factors in young breast cancer patients.MethodsData from four European Organisation for Research and Treatment of Cancer (EORTC) clinical trials were pooled, resulting in a dataset consisting of 9,938 early breast cancer patients with a median follow-up of 11 years. For 549 patients aged less than 40 years at the time of diagnosis, including 341 node negative patients who did not receive chemotherapy, paraffin tumor blocks were processed for immunohistochemistry using a tissue microarray. Cox proportional hazard analysis was applied to assess the association of clinical and pathological factors with overall and distant metastasis free survival.ResultsFor young patients, tumor size (P = 0.01), nodal status (P = 0.006) and molecular subtype (P = 0.02) were independent prognostic factors for overall survival. In the node negative subgroup, only molecular subtype was a prognostic factor for overall survival (P = 0.02). Young node negative patients bearing luminal A tumors had an overall survival rate of 94% at 10 years' follow-up compared to 72% for patients with basal-type tumors.ConclusionsMolecular subtype is a strong independent prognostic factor in breast cancer patients younger than 40 years of age. These data support the use of established prognostic factors as a diagnostic tool to assess disease outcome and to plan systemic treatment strategies in young breast cancer patients.
Highlights
Young age at the time of diagnosis of breast cancer is an independent factor of poor prognosis
In the node negative subgroup, only molecular subtype was a prognostic factor for overall survival (P = 0.02)
Molecular subtype is a strong independent prognostic factor in breast cancer patients younger than years of age. These data support the use of established prognostic factors as a diagnostic tool to assess disease outcome and to plan systemic treatment strategies in young breast cancer patients
Summary
Young age at the time of diagnosis of breast cancer is an independent factor of poor prognosis. Full list of author information is available at the end of the article prognosis in breast cancer, several current consensus guidelines have included age ≥ 35 years as an absolute indication for adjuvant systemic chemotherapy irrespective of other tumor characteristics [4,5,6]. These guidelines imply that for young patients with favorable tumor features such as small tumor size and negative axillary nodal status, adjuvant chemotherapy and hormonal therapy for patients with hormone receptor positive tumors is advised absolute treatment benefits are not well known. It has been demonstrated that an additional boost dose of radiotherapy after breast-conserving surgery decreases the risk of local recurrence especially in young women [8], but these loco-regional recurrence rates are still significantly higher compared with mastectomy in the young patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
