METHODS: In this retrospective study, we compared the clinical and tumor characteristics, the treatments, and the survival of 257 women aged ≤ 35 years, with 6566 women aged 50-69 years. We used a registry-based data of patients with invasive, non-metastatic breast cancer diagnosed between 2000 and 2015.
RESULTS: Young women showed lower rate of hormone receptor (HR) positivity. Their tumors were more often HER2-positive, which showed lower rate of differentiation and higher rate of Ki-67 expression compared to their older counterparts. Women aged 35 years and younger were more likely to undergo neoadjuvant therapy and mastectomy. Endocrine therapy was underrepresented in young patients. 5-Year disease-free survival (DFS) was significantly lower in the younger patient group (81.7% vs. 91.3%, p < 0.001), while 5-year overall survival (OS) was not impaired (91.4% vs. 91.1%, p = 0.847).
CONCLUSIONS: The unfavorable disease-free survival in the group of younger patients might be explained by their unfavorable tumor characteristics. The surgical treatment appears to be more aggressive in young breast cancer patients and is more frequently combined with chemotherapy and immunotherapy, either in a neoadjuvant or in an adjuvant setting.
方法:在这项回顾性研究中,我们比较了临床和肿瘤的特点,治疗,257名年龄≤35岁的女性的生存率,有6566名50-69岁的女性。我们使用了基于注册表的侵入性患者数据,在2000年至2015年间诊断为非转移性乳腺癌。
结果:年轻女性的激素受体(HR)阳性率较低。他们的肿瘤更常见的是HER2阳性,与年龄较大的同行相比,其分化率较低,Ki-67表达率较高。35岁及以下的女性更有可能接受新辅助治疗和乳房切除术。年轻患者的内分泌治疗代表性不足。年轻患者组的5年无病生存率(DFS)显着降低(81.7%vs.91.3%,p<0.001),而5年总生存率(OS)没有受损(91.4%vs.91.1%,p=0.847)。
结论:年轻患者组的无病生存不良可能是由其不良的肿瘤特征来解释的。年轻乳腺癌患者的手术治疗似乎更具侵略性,并且更频繁地与化学疗法和免疫疗法相结合。无论是在新佐剂或佐剂设置。