Annals of Oncology Advance Access originally published online on June 23, 2006
Annals of Oncology 2006 17(10):1497-1503; doi:10.1093/annonc/mdl145
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© 2006 European Society for Medical Oncology
breast cancer |
Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease
1 Research Unit in Medical Senology, Milan, Italy
2 Division of Epidemiology and Biostatistics, Milan, Italy
3 Division of Pathology, Milan, Italy
4 University of Milan School of Medicine, Milan, Italy
5 Division of Senology, Milan, Italy
6 Department of Medicine, European Institute of Oncology, Milan, Italy
*Correspondence to: Dr M. Colleoni, Unit of Research in Medical Senology, Department of Medicine, Istituto Europeo di Oncologia, Via Ripamonti 435, 20141, Milan, Italy. Tel: +39.02.57489439; Fax. +39.02.57489212; E-mail: marco.colleoni{at}ieo.it
Background: There is limited knowledge about prognosis, and treatment effects in young women with node-negative disease.
Patients and Methods: We evaluated biological features, treatment recommendations and prognosis for 841 premenopausal patients with pT1-3, pN0 and M0, operated from 1997 to 2001.
Results: Patients below 35 years (101, 12%) were more likely to have tumors > 2 cm (35.6% versus 24.2%, P = 0.002), grade 3 (48.5% versus 31.9%, P = 0.009) and with elevated Ki-67 expression (62.4% versus 50.7%, P = 0.002). At the multivariate analysis a statistically significant difference in disease-free survival (DFS, HR 4.44; 95% CI 2.53 to 7.78, P < 0.0001), risk of distant metastases (DDFS) (HR 3.23; 95% CI 1.32 to 7.94, P = 0.011) and overall survival (OS) (HR 2.89; 95% CI 1.06 to 7.87, P = 0.038) was observed for younger versus older patients and in the subgroup with endocrine responsive tumors (DFS, HR 5.17, 95% CI 2.72–9.83, P = < 0.0001; DDFS, 3.76, 95% CI 1.33–10.6, P = 0.013; OS, 4.71, 95% CI 1.09–20.4, P = 0.039 ).
Conclusions: Compared with less young, very young patients with endocrine responsive and node-negative breast cancer have a worse prognosis. Tailored treatments should be explored in this cohort of patients.
Key words: breast cancer, prognostic features, very young women, endocrine responsiveness
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