Abstract
BackgroundThe number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes.MethodsA retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤ 35 years of age with pathologically confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases (DM) were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastasis-free intervals.ResultsWe identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤ 35 years of age. The overall 5-year LR, RR, and DM rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P = 0.028 and P = 0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P = 0.004 and P = 0.007, respectively). Patients with HR−/HER2+ status had a significantly higher LR (HR 20.4; 95% CI, 11.8–35.4) and DM (HR 37.2; 95% CI, 24.6–56.3) at 10 years. Breast-conserving surgery (BCS) or mastectomy did not influence rates of LR and RR. In the overall population, the 5-year survival of YBC patients exceeded 90%.ConclusionsThe rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report the highest LR rates in this young population were associated with HR−/HER2+ tumors.
Highlights
It has been estimated that 4% of females < 40 years of age were diagnosed with breast cancer in the United States in 2017 and breast cancer is the leading cause of cancer deaths among women 20–59 years of age [1, 2]
Previous research showed that young women with breast cancer who undergo breast-conserving surgery (BCS) have higher rates of developing loco-regional recurrence (LRR) compared with women who undergo mastectomy, but the overall survival (OS) is not affected [12, 13]
There has been a significant decline in the occurrence of distant metastases (DM) [17, 18] and increase in the OS over the last years in young breast cancer (YBC) patients owing to the evolution of improved adjuvant systemic treatment and raising consciousness of physical examination [19, 20]
Summary
Prior studies have revealed that young age is a known risk prognostic factor for breast cancer patients [3,4,5,6,7,8]. This finding is reflected by larger tumors, higher grade, advanced stage, more lymph node metastases, a higher prevalence of human epidermal growth factor receptor (HER) over-expression, and estrogen receptor (ER) negativity in young women with breast cancer [4, 5, 7]. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes
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
