Prognostic Factors and Survival of Women with Breast Cancer Under 40 Years Old: A Single-Centre Experience

Berrin Inanc 1 * , Ozlem Mermut 1
More Detail
1 Department of Radiation Oncology, University of Health Sciences, Istanbul Education and Research Hospital, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 3, Issue 57, pp. 39-44. https://doi.org/10.23950/1812-2892-JCMK-00773
OPEN ACCESS 2136 Views 1521 Downloads
Download Full Text (PDF)

ABSTRACT

Objective: This retrospective research aimed to evaluate the results of treatment outcome and clinicopathological features of breast cancer patients under 40 years old.
Material and methods: A total of 80 patients who were receiving radiotherapy and/or chemotherapy treatment for breast cancer (<40 years old) were included in the study. 
Results: First-degree relatives with breast cancer history (p=0.028), oestrogen receptor positivity (p=0.012) and progesterone receptor positivity (p=0.017) were associated with overall survival. No prognostic factors were found in the multivariate Cox regression analysis for overall survival. In multivariate Cox regression analysis, we found breast-conserving surgery type (hazard ratio = 6.104. 95% confidence interval = 1.037–53.928, p=0.045), lymphovascular invasion presence (hazard ratio = 0.127, 95% confidence interval = 0.016–1.025, p=0.005) and curative radiotherapy doses (hazard ratio = 185.976, 95% confidence interval = 5.342–6474.1, p=0.004) as independent prognostic factors for disease-free survival. Overall, survival of 1, 3 and 5 years was 88%, 74% and 65%, respectively. Median was 48±2.6 (42.8–53.19) months. Also, 1-, 3- and 5-year disease-free survival was 85%, 67% and 27%, respectively. Median was 30±1.8 (27.4–32.5) months.
Conclusion: Breast cancer patients under the age of 40 years are highly heterogeneous and are a complex patient group. The prognosis is worse in these patients, and prognostic factors and pathological subtypes should be taken into consideration when making treatment decisions.
Keywords: breast cancer, prognostic factors, younger patients

CITATION

Inanc B, Mermut O. Prognostic Factors and Survival of Women with Breast Cancer Under 40 Years Old: A Single-Centre Experience. Journal of Clinical Medicine of Kazakhstan. 2020;3(57):39-44. https://doi.org/10.23950/1812-2892-JCMK-00773

REFERENCES

  • Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020; 70:7-30. https://doi.org/10.3322/caac.21590
  • Leong SP, Shen ZZ, Liu TJ, Agarwal G, Tajima T, Paik NS, et al. Is Breast Cancer the Same Disease in Asian and Western Countries? World J Surg. 2010; 34:2308–2324. https://doi.org/10.1007/s00268-010-0683-1
  • Parker JS, Mullins M, Cheang MC, Leung S, Voduc D, Vickery T, et al. Supervised risk predictor of breast cancer based on intrinsic subtypes. J Clin Oncol. 2009; 27:1160–1167. https://doi.org/10.1200/JCO.2008.18.1370
  • Gnerlich J, Deshpande A, Jeffe D, Sweet A, White N, Margenthaler J. Elevated breast cancer mortality in young women (<40 yrs) compared with older women is attributed to poorer survival in early stage disease. J Am Coll Surg. 2009; 208(3):341-7. https://doi.org/10.1016/j.jamcollsurg.2008.12.001
  • Rodrэґguez-Cuevas S, Macэґas CG, Franceschi D, Labastida S. Breast Carcinoma Presents a Decade Earlier in Mexican Women than in Women in the United States or European Countries. Cancer. 2001; 91:863–868. https://doi.org/10.1002/1097-0142(20010215)91:4<863::AID-CNCR1074>3.0.CO;2-Y
  • Chia KS, Du WB, Sankaranarayanan R, Sankila R, Wang H, Lee J, et al. Do younger female breast cancer patients have a poorer prognosis? Results from a population-based survival analysis. Int J Cancer. 2004; 108:761–765. https://doi.org/10.1002/ijrc.11632
  • Chung M, Chang HR, Bland KI, Wanebo HJ. Younger women with breast carcinoma have a poorer prognosis than older women. Cancer. 1996; 77:97–103. https://doi.org/10.1002/(SICI)1097-0142(19960101)77:1<97::AID-CNCR16>3.0.CO;2-3
  • Brewer HR, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ. Family history and risk of breast cancer: an analysis accounting for family structure. Breast Cancer Res Treat. 2017; 165(1):193–200. https://doi.org/10.1007/s10549-017-4325-2
  • Vila J, Gandini S, Gentilini O. Overall survival according to type of surgery in young (≤40years) early breast cancer patients: a systematic meta‐analysis comparing breast‐conserving surgery versus mastectomy. Breast. 2015; 24:175–181. https://doi.org/10.1016/j.breast.2015.02.002
  • Laurberg T, Lyngholm CD, Christiansen P, Alsner J, Overgaard J. Long‐term age‐dependent failure pattern after breast‐conserving therapy or mastectomy among Danish lymph‐node‐negative breast cancer patients. Radiother Oncol. 2016; 120:98–106. https://doi.org/10.1016/j.radonc.2016.05.006
  • Schoppmann SF, Bayer G, Aumayr K, et al. Prognostic value of lymphangiogenesis and lymphovascular invasion in invasive breast cancer. Ann Surg. 2004; 240(2):306–312. https://doi.org/10.1097/01.sla.0000133355.48672.22
  • Fein DA, Fowble BL, Hanlon AL, et al. Identification of women with T1-T2 breast cancer at low risk of positive axillary nodes. J Surg Oncol. 1997; 65:34–39. https://doi.org/10.1002/(sici)1096-9098(199705)65:1%3C34::aid-jso7%3E3.0.co;2-p
  • Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011; 378(9804):1707–16. https://doi.org/10.1016/S0140-6736(11)61629
  • Bartelink H, Horiot JC, Poortmans PM, Struikmans H, Van den Bogaert W, Fourquet A, et al. Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol. 2007; 25(22):3259–65. https://doi.org/10.1200/jco.2007.11.4991
  • Davidson NE, O’Neill AM, Vukov AM, Osborne CK, Martino S, White DR, et al. Chemoendocrine therapy for premenopausal women with axillary lymph node-positive, steroid hormone receptor-positive breast cancer: results from INT 0101 (E5188). J Clin Oncol. 2005; 23:5973–5982. https://doi.org/10.1200/JCO.2005.05.551
  • Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, et al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet. 2011; 378:771–784. https://doi.org/10.1016/S0140-6736(11)60993-8
  • Hernandez-Aya LF, Chavez-MacGregor M, Lei X, Meric-Bernstam F, Buchholz T, Hsu L, et al. Nodal status and clinical outcomes in a large cohort of patients with triple-negative breast cancer. J Clin Oncol. 2011; 29:2628–2634. https://doi.org/10.1200/JCO.2010.32.1877
  • Foulkes WD, Smith IE, Reis-Filho JS. Triple-negative breast cancer. N Engl J Med. 2010; 363:1938–1948. https://doi.org/10.1056/NEJMra1001389
  • Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California Cancer Registry. Cancer. 2007; 109:1721–1728. https://doi.org/10.1002/cncr.22618