Improved survival in young women with breast cancer
- 26 Downloads
Background: Young age has been hypothesized to be an adverse prognostic factor for women with breast cancer. This association, based on historical data, may not reflect recent advances in breast cancer management.
Methods: A retrospective study was conducted of all women age 30 or younger who underwent definitive operation at our institution for primary operable breast carcinoma during one of two consecutive 20-year periods (1950–1969 or 1970–1989). All cancers were restaged according to current staging criteria. Actuarial survival and recurrence-free survival rates from the two patient eras were compared with each other and with published statistics for older breast cancer patients.
Results: Eligibility criteria were met by 81 women from the 1950–1969 era and 146 women from the 1970–1989 era. Histologic diagnoses, tumor sizes, incidence of axillary nodal metastases, number of positive nodes, and American Joint Committee on Cancer stage at presentation were similarly distributed in the two eras. Despite these similarities, improved survival (p=0.009) was observed in the later era. Local recurrences were also more common (p<0.05) in the later era in association with less extensive resections. These local recurrences had an adverse impact on recurrence-free survival in the later era, but no concomitant decrease in overall survival was observed. Node-positive patients who received chemotherapy demonstrated a trend toward improved survival (p=0.06) compared with node-positive patients who did not. Survival for patients in the later era was similar to that for older women as reported in other published series.
Conclusions: The stage of presentation of breast cancer in women 30 years or younger appears unchanged from prior decades, but survival has improved in association with the use of less extensive surgical resections and the introduction of cytotoxic chemotherapy. With current treatment, primary operable breast cancer in young women appears to have a similar prognosis to breast cancer in older women.
Key WordsBreast cancer Young age Local recurrence Chemotherapy
Unable to display preview. Download preview PDF.
- 1.Ewing J. Epithelial and other tumors of the breast. In: Ewing J, ed.Neoplastic diseases, a treatise on tumors, 4th ed. Philadelphia: WB Saunders, 1940:587–8.Google Scholar
- 4.Editorial. Breast cancer in young women.Br Med J 1975;2:649–50.Google Scholar
- 6.Swanson GM. Breast cancer in younger women: survival patterns.Female Patient 1993;18:53–6.Google Scholar
- 9.Breast cancer in young women: more questions than answers.Oncol Bull 1993;16:14–8.Google Scholar
- 10.Qualters JR, Lee NC, Smith RA, Aubert RE. Breast and cervical cancer surveillance, United States, 1973–1987.Morbidity Mortality Weekly Rep 1992;41:1–15.Google Scholar
- 12.Breast cancer staging. In: American Joint Committee on Cancer.Manual for staging of cancer, 4th ed. Philadelphia: JB Lippincott, 1992:149–54.Google Scholar
- 13.Kaplan EL, Meier P. Nonparametric estimation from incomplete observations.Am Stat Assoc J 1958;53:457–81.Google Scholar
- 14.Glantz SA. The chi-square test statistic. In:Primer of biostatistics, 2nd ed. New York: McGraw-Hill, 1987:122–6.Google Scholar
- 18.Smart CR, Hartmann WH, Beahrs OH, Garfinkel L. Insights into breast cancer screening of younger women.Cancer Suppl 1993;72:1449–56.Google Scholar
- 19.Liberman L, Giess C, Borgen PI, Deutch BM, Dershaw DD. Presented at the 78th Scientific Assembly of the Radiologic Society of North America, Chicago, Illinois, 1992.Google Scholar
- 22.Senie RT, Simkovich A, Kinne DW, Borgen PI. Generational shifting in mean age at diagnosis of breast cancer [Abstract].Breast Cancer Res Treat 1993;27:173.Google Scholar