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Long-term outcome in young women with breast cancer: a population-based study
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Breast & Endocrine Surg, S-17176 Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology. Uppsala University, Science for Life Laboratory, SciLifeLab.
Karolinska Inst, Dept Biosci & Nutr, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Kings Coll London, Fac Life Sci & Med, Div Canc Studies, London, England..
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2016 (English)In: Breast Cancer Research and Treatment, ISSN 0167-6806, E-ISSN 1573-7217, Vol. 160, no 1, 131-143 p.Article in journal (Refereed) Published
Abstract [en]

Whether young age at diagnosis of breast cancer is an independent risk factor for death remains controversial, and the question whether young age should be considered in treatment decisions is still to be answered. From a population-based cohort of 22,017 women with breast cancer, all women < 35 years (n = 471) were compared to a random sample of 700 women aged 35-69 years from the same cohort. Information on patient and tumor characteristics, treatment, and follow-up was collected from the medical records. Tissue microarrays were produced for analysis of classical biomarkers. Breast cancer-specific survival (BCSS), distant disease-free survival (DDFS), and locoregional recurrence-free survival (LRFS) by age were compared using women 50-69 years as reference. At 10 years follow-up, women < 35 years and 35-39 years had a worse BCSS [age < 35 years 69 % (HR 2.75, 95 % CI 1.93-3.94), age 35-39 years 76 % (HR 2.33, 95 % CI 1.54-3.52), age 40-49 years 84 % (HR 1.53, 95 % CI 0.97-2.39), and age 50-69 years 89 % (reference)]. The worse BCSS was statistically significant in stages I-IIa and Luminal B tumors. At multivariate analysis age < 35 years and 35-39 years confined a risk in LRFS (HR 2.13, 95 % CI 1.21-3.76 and HR 1.97, 95 % CI 1.06-3.68) but not in DDFS and BCSS. In the subgroup of women < 40 years with luminal tumors stage I-IIa, low age remained an independent risk factor also in DDFS (HR 1.87, 95 % CI 1.03-3.44). Young women have a high risk of systemic disease even when diagnosed in an early stage. The excess risk of relapse is most pronounced in Luminal B tumors, where low age is an independent prognostic factor of DDFS and LRFS.

Place, publisher, year, edition, pages
2016. Vol. 160, no 1, 131-143 p.
Keyword [en]
Breast cancer, Young age, Subtype, Luminal B, Early stage, Prognosis, Population-based
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-307262DOI: 10.1007/s10549-016-3983-9ISI: 000385175900013PubMedID: 27624330OAI: oai:DiVA.org:uu-307262DiVA: diva2:1046457
Funder
Stockholm County CouncilThe Karolinska Institutet's Research FoundationSwedish Cancer SocietySwedish Research Council, 524-2011-6857Knut and Alice Wallenberg Foundation
Available from: 2016-11-14 Created: 2016-11-11 Last updated: 2016-11-14Bibliographically approved

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Fält, Sonja EakerLindman, HenrikHolmberg, LarsPontén, Fredrik
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Department of Immunology, Genetics and PathologyScience for Life Laboratory, SciLifeLabDepartment of Surgical SciencesEndocrine SurgeryDepartment of Radiology, Oncology and Radiation Science
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