Skip to main content

Advertisement

Log in

Time-trends in survival in young women with breast cancer in a SEER population-based study

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Mortality improvements in young women with breast cancer (BC) may be attributable to treatment advances; screening likely plays a less significant role as mammography is not recommended <40. We examined time-trends in outcome in a cohort of young women. Our goal was to determine the contributions of treatment and screening to mortality improvements and evaluate whether differential outcomes by ER status exist. Using SEER, patients (73,447) were divided into three categories by diagnosis year (1990–1994, 1995–1999, 2000–2004) and also categorized as <40 or 40–50 years. Multivariate analysis was done to investigate the association of survival with time period for both age groups by ER status. Hazard ratios (HR) for mortality in women 40–50 with ER positive BC declined over time. With 1990–1994 as referent, the HR in 1995–1999 was 0.77 (0.69–0.86) and 0.65 (0.59–0.71) in 2000–2004 (p < 0.001). Women <40 with ER positive BC also had improvements over time. In ER negative patients, the degree of improvements over time was less than that seen in ER positive women. We report a survival disparity over time in young women by ER status. Patients with ER negative disease have not had the degree of improvements over time as seen in ER positive disease. Therefore, mortality improvements in young women with ER positive BC may be attributed to treatment advances with endocrine agents.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. ACS (2011) Breast Cancer Facts & Figures 2011–2012. American Cancer Society, Atlanta

  2. Bleyer A, Barr R, Hayes-Lattin B et al (2008) The distinctive biology of cancer in adolescents and young adults. Nat Rev Cancer 8:288–298

    Article  PubMed  CAS  Google Scholar 

  3. de la Rochefordiere A, Asselain B, Campana F et al (1993) Age as prognostic factor in premenopausal breast carcinoma. Lancet 341:1039–1043

    Article  PubMed  Google Scholar 

  4. Anders CK, Hsu DS, Broadwater G et al (2008) Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol 26:3324–3330

    Article  PubMed  Google Scholar 

  5. Kurian AW, Fish K, Shema SJ et al (2010) Lifetime risks of specific breast cancer subtypes among women in four racial/ethnic groups. Breast Cancer Res 12:R99

    Article  PubMed  Google Scholar 

  6. Telli ML, Chang ET, Kurian AW et al (2011) Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry. Breast Cancer Res Treat 127:471–478

    Article  PubMed  Google Scholar 

  7. Carey LA, Perou CM, Livasy CA et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA 295:2492–2502

    Article  PubMed  CAS  Google Scholar 

  8. Colleoni M, Rotmensz N, Robertson C et al (2002) Very young women (<35 years) with operable breast cancer: features of disease at presentation. Ann Oncol 13:273–279

    Article  PubMed  CAS  Google Scholar 

  9. Lund MJ, Trivers KF, Porter PL et al (2009) Race and triple negative threats to breast cancer survival: a population-based study in Atlanta, GA. Breast Cancer Res Treat 113:357–370

    Article  PubMed  Google Scholar 

  10. Althuis MD, Brogan DD, Coates RJ et al (2003) Breast cancers among very young premenopausal women (United States). Cancer Causes Control 14:151–160

    Article  PubMed  Google Scholar 

  11. Shavers VL, Harlan LC, Stevens JL (2003) Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35. Cancer 97:134–147

    Article  PubMed  Google Scholar 

  12. Chung M, Chang HR, Bland KI et al (1996) Younger women with breast carcinoma have a poorer prognosis than older women. Cancer 77:97–103

    Article  PubMed  CAS  Google Scholar 

  13. Adami HO, Malker B, Holmberg L et al (1986) The relation between survival and age at diagnosis in breast cancer. N Engl J Med 315:559–563

    Article  PubMed  CAS  Google Scholar 

  14. Winchester DP, Osteen RT, Menck HR (1996) The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer 78:1838–1843

    Article  PubMed  CAS  Google Scholar 

  15. Berry DA, Cronin KA, Plevritis SK et al (2005) Effect of screening and adjuvant therapy on mortality from breast cancer. N Engl J Med 353:1784–1792

    Article  PubMed  CAS  Google Scholar 

  16. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717

    Google Scholar 

  17. Giordano SH, Buzdar AU, Smith TL et al (2004) Is breast cancer survival improving? Cancer 100:44–52

    Article  PubMed  Google Scholar 

  18. Dawood S, Broglio K, Gonzalez-Angulo AM et al (2008) Trends in survival over the past two decades among white and black patients with newly diagnosed stage IV breast cancer. J Clin Oncol 26:4891–4898

    Article  PubMed  Google Scholar 

  19. Eheman C, Henley SJ, Ballard-Barbash R et al (2012) Annual report to the nation on the status of cancer, 1975–2008, featuring cancers associated with excess weight and lack of sufficient physical activity. Cancer 118(9):2338–2366

    Google Scholar 

  20. Howlader N, Noone AM, Krapcho M et al (2012) SEER Cancer Statistics Review, 1975–2009. National Cancer Institute, Bethesda

  21. Haggstrom DA, Quale C, Smith-Bindman R (2005) Differences in the quality of breast cancer care among vulnerable populations. Cancer 104:2347–2358

    Article  PubMed  Google Scholar 

  22. Kadaoui N, Guay M, Baron G et al (2012) Breast cancer screening practices for women aged 35 to 49 and 70 and older. Can Fam Physician 58:e47–e53

    PubMed  Google Scholar 

  23. Elkin EB, Ishill NM, Snow JG et al (2010) Geographic access and the use of screening mammography. Med Care 48:349–356

    Article  PubMed  Google Scholar 

  24. Autier P, Boniol M, Gavin A et al (2011) Breast cancer mortality in neighbouring European countries with different levels of screening but similar access to treatment: trend analysis of WHO mortality database. BMJ 343:d4411

    Article  PubMed  Google Scholar 

  25. Porter PL, El-Bastawissi AY, Mandelson MT et al (1999) Breast tumor characteristics as predictors of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst 91:2020–2028

    Article  PubMed  CAS  Google Scholar 

  26. Collett K, Stefansson IM, Eide J et al (2005) A basal epithelial phenotype is more frequent in interval breast cancers compared with screen detected tumors. Cancer Epidemiol Biomarkers Prev 14:1108–1112

    Article  PubMed  CAS  Google Scholar 

  27. Pagani O, O’Neill A, Castiglione M et al (1998) Prognostic impact of amenorrhoea after adjuvant chemotherapy in premenopausal breast cancer patients with axillary node involvement: results of the International Breast Cancer Study Group (IBCSG) Trial VI. Eur J Cancer 34:632–640

    Article  PubMed  CAS  Google Scholar 

  28. Parulekar WR, Day AG, Ottaway JA et al (2005) Incidence and prognostic impact of amenorrhea during adjuvant therapy in high-risk premenopausal breast cancer: analysis of a National Cancer Institute of Canada Clinical Trials Group Study–NCIC CTG MA.5. J Clin Oncol 23:6002–6008

    Article  PubMed  Google Scholar 

  29. Ademuyiwa FO, Groman A, O’Connor T et al (2011) Impact of body mass index on clinical outcomes in triple-negative breast cancer. Cancer 117:4132–4140

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Foluso O. Ademuyiwa.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 48 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ademuyiwa, F.O., Groman, A., Hong, CC. et al. Time-trends in survival in young women with breast cancer in a SEER population-based study. Breast Cancer Res Treat 138, 241–248 (2013). https://doi.org/10.1007/s10549-013-2425-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-013-2425-1

Keywords

Navigation