Advertisement

Do young breast cancer patients have worse outcomes?

      Abstract

      Introduction

      Previous studies have suggested that young breast cancer patients have poorer survival as compared with their older counterparts. Most of this research reflects single institution experiences that may not be representative of the population. This study was designed to determine whether young breast cancer patients have poorer survival as compared with an older cohort using a national population-based cancer registry and, more specifically, to determine whether differences in survival are caused by more advanced tumor stage, more aggressive disease, or patient-specific characteristics.

      Materials and methods

      Using the Surveillance, Epidemiology, and End Results cancer database (1992–1998), data for all patients with a diagnosis of invasive breast cancer were extracted. Two age categories were analyzed: young group (≤35 years old, n = 4,616) and older group (50–55 years old, n = 20,319). Patient demographics, 5-year survival rates, tumor characteristics (stage, grade, and receptor status), surgical treatment, and use of radiation were compared between the groups.

      Results

      Overall, young patients had worse 5-year survival when compared with the older group (74.3% vs. 85.1%). Stage for stage, the young patients also had poorer survival (except for stage IV). They present with more advanced stage disease and have more aggressive tumor characteristics, that is, higher grade tumors and more estrogen- and progesterone receptor-negative tumors. Even after controlling for patient characteristics, tumor factors, and receipt of treatment, a multivariate regression showed that young age was an independent risk factor for death (HR = 1.095).

      Conclusions

      Young breast cancer patients have poorer outcomes, which are in part attributed to later stage disease, more aggressive tumors, and less favorable receptor status. There still appears to be other important factors, not included in our study, that are contributing to the worse outcomes for these young patients, such as socioeconomic status. Physicians need to have heightened awareness when evaluating this population, and increasingly efficacious adjuvant therapies need to be developed.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Surgical Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. National Cancer Institute. Available at: http://seer.cancer.gov/ Accessed December 31, 2002

      2. American Cancer Society. Available at: http://www.cancer.org/ Accessed December 31, 2002

        • Kothari A.S.
        • Beechey-Newman N.
        • D'Arrigo C.
        • Hanby A.M.
        • Ryder K.
        • Hamed H.
        • Fentiman I.S.
        Breast carcinoma in women age 25 years or less.
        Cancer. 2002; 94: 606
        • Xiong Q.
        • Valero V.
        • Kau V.
        • Kau S.W.
        • Taylor S.
        • Smith T.L.
        • Buzdar A.U.
        • Hortobagyi G.N.
        • Theriault R.L.
        Female patients with breast carcinoma age 30 years and younger have a poor prognosis.
        Cancer. 2001; 92: 2523
        • Love R.R.
        • Duc N.B.
        • Dinh N.V.
        • Quy T.T.
        • Xin Y.
        • Havighurst T.C.
        Young age as an adverse prognostic factor in premenopausal women with operable breast cancer.
        Clin. Breast Cancer. 2002; 2: 294
        • Dubsky P.C.
        • Gnant M.F.
        • Taucher S.
        • Roka S.
        • Kandioler D.
        • Pichler-Gebhard B.
        • Agstner I.
        • Seifert M.
        • Sevelda P.
        • Jakesz R.
        Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer.
        Clin. Breast Cancer. 2002; 3: 65
        • Biffl W.L.
        • Myers A.
        • Franciose R.J.
        • Gonzalez R.J.
        • Darnell D.
        Is breast cancer in young Latinas a different disease.
        Am. J. Surg. 2001; 182: 596
        • Yildirim E.
        • Dalgic T.
        • Berberoglu U.
        Prognostic significance of young age in breast cancer.
        J. Surg. Oncol. 2000; 74: 267
        • Jimor S.
        • Al-Sayer H.
        • Heys S.D.
        • Payne S.
        • Miller I.
        • Ah-See A.
        • Hutcheon A.
        • Eremin O.
        Breast cancer in women aged 35 and under.
        J R Coll. Surg. Edinb. 2002; 47: 693
        • Kothari A.S.
        • Fentiman I.S.
        11. Breast cancer in young women.
        Int. J. Clin. Pract. 2002; 56: 184
        • Gajdos C.
        • Tartter P.I.
        • Bleiweiss I.J.
        • et al.
        Stage 0 to stage iii breast cancer in young women.
        J. Am. Coll. Surg. 2000; 190: 523
      3. NIH consensus conference: Treatment of early stage breast cancer, 1990. Available at: http://consensus.nih.gov

      4. North American Association of Central Cancer Registries. Available at: http://www.naaccr.org

        • Virnig B.A.
        • Warren J.L.
        • Cooper G.S.
        • Klabunde C.N.
        • Schussler N.
        • Freeman J.
        Studying radiation therapy using SEER-Medicare-linked data.
        Med. Care. 2002; 40: IV