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 accessOne-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 ResearchAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
National Cancer Institute. Available at: http://seer.cancer.gov/ Accessed December 31, 2002
American Cancer Society. Available at: http://www.cancer.org/ Accessed December 31, 2002
- Breast carcinoma in women age 25 years or less.Cancer. 2002; 94: 606
- Female patients with breast carcinoma age 30 years and younger have a poor prognosis.Cancer. 2001; 92: 2523
- Young age as an adverse prognostic factor in premenopausal women with operable breast cancer.Clin. Breast Cancer. 2002; 2: 294
- Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer.Clin. Breast Cancer. 2002; 3: 65
- Is breast cancer in young Latinas a different disease.Am. J. Surg. 2001; 182: 596
- Prognostic significance of young age in breast cancer.J. Surg. Oncol. 2000; 74: 267
- Breast cancer in women aged 35 and under.J R Coll. Surg. Edinb. 2002; 47: 693
- 11. Breast cancer in young women.Int. J. Clin. Pract. 2002; 56: 184
- Stage 0 to stage iii breast cancer in young women.J. Am. Coll. Surg. 2000; 190: 523
NIH consensus conference: Treatment of early stage breast cancer, 1990. Available at: http://consensus.nih.gov
North American Association of Central Cancer Registries. Available at: http://www.naaccr.org
- Studying radiation therapy using SEER-Medicare-linked data.Med. Care. 2002; 40: IV
Article info
Publication history
Received:
January 1,
2003
Footnotes
☆This work was supported by the Robert Wood Johnson Clinical Scholars Program, Veterans Affairs, UCLA.
Identification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
