PDF(Pubmed)
Abstract：
UNASSIGNED: Breast cancer (BC) in adolescents and young adults (AYAs, aged 15-39 years), remains inadequately understood. The incidence of BC in AYAs has been steadily increasing, making it the second leading cause of cancer-related mortality among females aged 0-39 globally. This study aimed to elucidate the clinical characteristics and long-term outcomes of AYAs and older adults (OAs, aged > 39 years) with BC who underwent surgery.
UNASSIGNED: From January 2011 to June 2017, BC patients who underwent surgery were enrolled in this study and divided into AYA group and OA group. Clinical characteristics, recurrence-free survival (RFS), and overall survival (OS) were compared between these two groups, both before and after propensity score matching (PSM). Univariate and multivariate Cox proportional hazard regression analyses were performed to assess the influence of age on OS and RFS.
UNASSIGNED: Compared to the OA group, the AYA group exhibited a younger age at menarche (p < 0.001), a lower prevalence of menopausal status (p < 0.001), a reduced occurrence of comorbid conditions (p < 0.001), fewer instances of undergoing mastectomy (p = 0.031), a higher incidence of Triple-Negative Breast Cancer (TNBC) (p = 0.046), and elevated Ki-67 levels (p = 0.036). In terms of prognostic outcomes, within the study cohort, AYAs had a higher mortality rate and poorer long-term survival compared to OAs, both before and after PSM. In the PSM cohort, AYAs experienced a significantly shorter median OS (p < 0.001) and RFS (p < 0.001). Young age (15-39 years) emerged as an independent risk factor for OS (HR 2.659, 95% CI 1.385-5.106, p = 0.003) and RFS (HR 3.235, 95% CI 2.085-5.022, p < 0.001) in BC patients following surgery.
UNASSIGNED: Significant differences were identified in the clinicopathological characteristics between AYA and OA patients with BC. In comparison to OA patients, AYA patients exhibited a less favorable long-term prognosis, with young age emerging as an independent prognostic risk factor for both OS and RFS in BC patients following surgery. Further investigations are warranted to develop age-specific therapeutic approaches for AYA BC patients.
UNASSIGNED: From January 2011 to June 2017, BC patients who underwent surgery were enrolled in this study and divided into AYA group and OA group. Clinical characteristics, recurrence-free survival (RFS), and overall survival (OS) were compared between these two groups, both before and after propensity score matching (PSM). Univariate and multivariate Cox proportional hazard regression analyses were performed to assess the influence of age on OS and RFS.
UNASSIGNED: Compared to the OA group, the AYA group exhibited a younger age at menarche (p < 0.001), a lower prevalence of menopausal status (p < 0.001), a reduced occurrence of comorbid conditions (p < 0.001), fewer instances of undergoing mastectomy (p = 0.031), a higher incidence of Triple-Negative Breast Cancer (TNBC) (p = 0.046), and elevated Ki-67 levels (p = 0.036). In terms of prognostic outcomes, within the study cohort, AYAs had a higher mortality rate and poorer long-term survival compared to OAs, both before and after PSM. In the PSM cohort, AYAs experienced a significantly shorter median OS (p < 0.001) and RFS (p < 0.001). Young age (15-39 years) emerged as an independent risk factor for OS (HR 2.659, 95% CI 1.385-5.106, p = 0.003) and RFS (HR 3.235, 95% CI 2.085-5.022, p < 0.001) in BC patients following surgery.
UNASSIGNED: Significant differences were identified in the clinicopathological characteristics between AYA and OA patients with BC. In comparison to OA patients, AYA patients exhibited a less favorable long-term prognosis, with young age emerging as an independent prognostic risk factor for both OS and RFS in BC patients following surgery. Further investigations are warranted to develop age-specific therapeutic approaches for AYA BC patients.
摘要：
■青少年和年轻人的乳腺癌（BC）（AYAs，15-39岁)，仍然没有得到充分的理解。AYAs中BC的发病率一直在稳步上升，使其成为全球0-39岁女性癌症相关死亡率的第二大原因。本研究旨在阐明AYAs和老年人(OAs，年龄>39岁)接受手术的BC。
■2011年1月至2017年6月，选择接受手术治疗的BC患者，分为AYA组和OA组。临床特征,无复发生存率（RFS），比较两组的总生存期(OS),倾向评分匹配(PSM)前后。进行单变量和多变量Cox比例风险回归分析以评估年龄对OS和RFS的影响。
■与OA组相比，AYA组初潮年龄较小(p<0.001)，更年期状态的患病率较低（p<0.001），减少合并症的发生(p<0.001)，接受乳房切除术的实例较少（p=0.031），三阴性乳腺癌（TNBC）的发病率较高（p=0.046），Ki-67水平升高（p=0.036）。就预后结果而言，在研究队列中，与OAs相比，AYAs的死亡率更高，长期生存率更差，在PSM之前和之后。在PSM队列中，AYAs经历了显著较短的中位OS(p<0.001)和RFS(p<0.001)。年轻年龄（15-39岁）是手术后BC患者OS（HR2.659，95％CI1.385-5.106，p=0.003）和RFS（HR3.235，95％CI2.085-5.022，p<0.001）的独立危险因素。
■AYA和OA合并BC患者的临床病理特征存在显著差异。与OA患者相比，AYA患者的长期预后较差，年轻是BC患者术后OS和RFS的独立预后危险因素。需要进一步的研究来开发针对AYABC患者的年龄特异性治疗方法。
■2011年1月至2017年6月，选择接受手术治疗的BC患者，分为AYA组和OA组。临床特征,无复发生存率（RFS），比较两组的总生存期(OS),倾向评分匹配(PSM)前后。进行单变量和多变量Cox比例风险回归分析以评估年龄对OS和RFS的影响。
■与OA组相比，AYA组初潮年龄较小(p<0.001)，更年期状态的患病率较低（p<0.001），减少合并症的发生(p<0.001)，接受乳房切除术的实例较少（p=0.031），三阴性乳腺癌（TNBC）的发病率较高（p=0.046），Ki-67水平升高（p=0.036）。就预后结果而言，在研究队列中，与OAs相比，AYAs的死亡率更高，长期生存率更差，在PSM之前和之后。在PSM队列中，AYAs经历了显著较短的中位OS(p<0.001)和RFS(p<0.001)。年轻年龄（15-39岁）是手术后BC患者OS（HR2.659，95％CI1.385-5.106，p=0.003）和RFS（HR3.235，95％CI2.085-5.022，p<0.001）的独立危险因素。
■AYA和OA合并BC患者的临床病理特征存在显著差异。与OA患者相比，AYA患者的长期预后较差，年轻是BC患者术后OS和RFS的独立预后危险因素。需要进一步的研究来开发针对AYABC患者的年龄特异性治疗方法。
