Abstract
Breast cancer stage at diagnosis, patient age and molecular tumor subtype influence disease progression. The aim of this study was to analyze the relationships between these factors and survival in breast cancer patients among the Italian population using data from the AIRTUM national database. We enrolled women with primary breast cancer from 17 population-based cancer registries. Patients were subdivided into older (>69 years), middle (50–69 years) and younger age groups (<50 years) and their primary tumors categorized into four molecular subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. There were 8831 patients diagnosed between 2010 and 2012 included. The most represented age group was 50–69 years (41.7%). In 5735 cases the molecular subtype was identified: HER2–/HR+ was the most frequent (66.2%) and HER2+/HR− the least (6.2%). Of the 390 women with metastases at diagnosis, 38% had simultaneous involvement of multiple sites, independent of age and molecular profile. In women with a single metastatic site, bone (20% of cases), liver (11%), lung (7%) and brain (3%) were the most frequent. In the studied age groups with different receptor expression profiles, the tumor metastasized to target organs with differing frequencies, affecting survival. Five-year survival was lowest in women with triple-negative (HER2−/HR–) tumors and women with brain metastases at diagnosis.
Highlights
Breast cancer is the most frequent cancer type among women: the estimated incidence in Italy in 2020 was just under 55,000 cases, with an estimated five-year survival rate of more than 87% [1]
The percentage of human epidermal growth factor receptor 2 (HER2)−/hormone receptor (HR)+ cases in our study increased from 61.8% in younger women to 65.8% and 69.8% in women in the middle and older age groups
This study focuses on the relationships between pattern of metastasis, molecular subtypes of breast cancer and age at diagnosis
Summary
Breast cancer is the most frequent cancer type among women: the estimated incidence in Italy in 2020 was just under 55,000 cases, with an estimated five-year survival rate of more than 87% [1]. Breast cancer is the neoplastic disease with the highest prevalence among women: 43% of Italian women live with a breast cancer diagnosis [1]. Breast cancer is the first cause of death among women. The prognosis is favorable in most cases, about 5–8% of women have distant metastases at the time of diagnosis and the five-year cause-specific survival for these patients is very low, ranging from 24% to 39% [2]. 90% of breast cancer deaths are attributable to metastases occurring during treatment [3]
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