Prognosis and adjuvant treatment effects in very young women (below 35 years) with operable breast cancer
Cancello, Giuseppe (2009) Prognosis and adjuvant treatment effects in very young women (below 35 years) with operable breast cancer. [Tesi di dottorato] (Inedito)
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Background: There is limited knowledge about prognosis of selected breast cancer subtypes among very young women Patients and Methods: We explored patterns of recurrence by age according to four immunohistochemically-defined tumor subtypes: triple negative, HER2 positive (and) endocrine receptor absent, Luminal A and Luminal B (ER-positive and/or PR-positive and either HER2-positive and/or high Ki67) in 2970 premenopausal patients with pT1-3, pN0-3 and M0 breast cancer. Results: Patients below 35 years of age (315, 11%) presented a significantly increased risk of recurrence and death (HR=1.65, 95%CI 1.30-2.10 and HR=1.78, 95%CI 1.12-2.85, respectively) when compared with older patients (2655, 89%) with similar characteristics of disease. This was true considering patients with luminal B (HR 1.62, 95%CI, 1.21-2.18, for DFS; HR 2.09, 95%CI, 0.96-4.53, for OS) and with triple-negative (HR 2.04, 95%CI, 1.11-3.72, for DFS; HR 2.20, 95%CI, 1.10-4.41, for OS) breast cancer, observing the highest risk of recurrence in the younger patients with HER2 positive breast cancer (HR 2.37, 95% CI, 1.12-5.02), when compared with older patients. Conclusions: Very young patients with triple negative, luminal B, or HER2 positive breast cancer have a worse prognosis when compared with older patients with similar characteristics of disease.
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