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Unfavourable clinicopathologic features and low response rate to systemic adjuvant therapy: results with regard to poor survival in young Chinese breast cancer patients

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Abstract

The prognostic factors of young breast cancer patients (BCPs) are still controversial. This study is aimed at evaluating the prognosis of young BCPs by characteristics and treatment response. We analysed the data on 2,593 operable BCPs age ≤50 years who were treated in the Cancer Hospital of Fudan University, Shanghai, China between 1990 and 2004. The overall survival and recurrence/metastasis-free survival were compared. In the study, 782 patients (30.2%) were ≤40 years, and 1,811 (69.8%) were 41–50 years old at their primary diagnosis. BCPs ≤40 years presented more unfavourable features than the 41–50 years BCPs (P < 0.05). They were more likely to experience death (P < 0.001) and recurrence/metastasis events (P < 0.001) even when they underwent the same adjuvant therapy in parallel with their counterparts (P < 0.05). In a multivariate analysis, age was an independent predictive factor for RFS (HR = 0.26, 95% CI = 0.44–0.89, P = 0.009) but not for OS (P > 0.05). Higher TNM stage and chemotherapy, but not HER2/neu over-expression, were predictive factors for young Chinese BCPs. The characteristics of breast cancer are more aggressive in young Chinese BCPs. Their prognostic factors are obviously different from those of the elder group. Current therapy was not as effective for them.

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References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, Thun MJ (2008) Cancer statistics, 2008. CA Cancer J Clin 58:71–96

    Article  PubMed  Google Scholar 

  2. Fan L, Zheng Y, Yu KD, Liu GY, Wu J, Lu JS, Shen KW, Shen ZZ, Shao ZM (2009) Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China. Breast Cancer Res Treat 117:409–416

    Google Scholar 

  3. Brinton LA, Sherman ME, Carreon JD, Anderson WF (2008) Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst 100:1643–1648

    Article  PubMed  Google Scholar 

  4. Colonna M, Delafosse P, Uhry Z, Poncet F, Arveux P, Molinie F, Cherie-Challine L, Grosclaude P (2008) Is breast cancer incidence increasing among young women? An analysis of the trend in France for the period 1983–2002. Breast 17:289–292

    Article  PubMed  Google Scholar 

  5. Yankaskas BC (2005) Epidemiology of breast cancer in young women. Breast Dis 23:3–8

    PubMed  Google Scholar 

  6. Ahn SH, Son BH, Kim SW, Kim SI, Jeong J, Ko SS, Han W (2007) Poor outcome of hormone receptor-positive breast cancer at very young age is due to tamoxifen resistance: nationwide survival data in Korea—a report from the Korean Breast Cancer Society. J Clin Oncol 25:2360–2368

    Article  PubMed  Google Scholar 

  7. Axelrod D, Smith J, Kornreich D, Grinstead E, Singh B, Cangiarella J, Guth AA (2008) Breast cancer in young women. J Am Coll Surg 206:1193–1203

    Article  PubMed  Google Scholar 

  8. Nixon AJ, Neuberg D, Hayes DF, Gelman R, Connolly JL, Schnitt S, Abner A, Recht A, Vicini F, Harris JR (1994) Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer. J Clin Oncol 12:888–894

    CAS  PubMed  Google Scholar 

  9. Rapiti E, Fioretta G, Verkooijen HM, Vlastos G, Schafer P, Sappino AP, Kurtz J, Neyroud-Caspar I, Bouchardy C (2005) Survival of young and older breast cancer patients in Geneva from 1990 to 2001. Eur J Cancer 41:1446–1452

    Article  PubMed  Google Scholar 

  10. McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM (2005) Reporting recommendations for tumor marker prognostic studies (REMARK). J Natl Cancer Inst 97:1180–1184

    Article  CAS  PubMed  Google Scholar 

  11. Dubsky PC, Gnant MF, Taucher S, Roka S, Kandioler D, Pichler-Gebhard B, Agstner I, Seifert M, Sevelda P, Jakesz R (2002) Young age as an independent adverse prognostic factor in premenopausal patients with breast cancer. Clin Breast Cancer 3:65–72

    Article  PubMed  Google Scholar 

  12. Sidoni A, Cavaliere A, Bellezza G, Scheibel M, Bucciarelli E (2003) Breast cancer in young women: clinicopathological features and biological specificity. Breast 12:247–250

    Article  CAS  PubMed  Google Scholar 

  13. Maggard MA, O’Connell JB, Lane KE, Liu JH, Etzioni DA, Ko CY (2003) Do young breast cancer patients have worse outcomes? J Surg Res 113:109–113

    Article  PubMed  Google Scholar 

  14. Vanlemmens L, Hebbar M, Peyrat JP, Bonneterre J (1998) Age as a prognostic factor in breast cancer. Anticancer Res 18:1891–1896

    CAS  PubMed  Google Scholar 

  15. Goldhirsch A, Gelber RD, Yothers G, Gray RJ, Green S, Bryant J, Gelber S, Castiglione-Gertsch M, Coates AS (2001) Adjuvant therapy for very young women with breast cancer: need for tailored treatments. J Natl Cancer Inst Monogr 4:4–51

    Google Scholar 

  16. Colleoni M, Rotmensz N, Peruzzotti G, Maisonneuve P, Orlando L, Ghisini R, Viale G, Pruneri G, Veronesi P, Luini A, Intra M, Cardillo A, Torrisi R, Rocca A, Goldhirsch A (2006) Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease. Ann Oncol 17:1497–1503

    Article  CAS  PubMed  Google Scholar 

  17. Walker RA, Lees E, Webb MB, Dearing SJ (1996) Breast carcinomas occurring in young women (<35 years) are different. Br J Cancer 74:1796–1800

    CAS  PubMed  Google Scholar 

  18. Albain KS, Allred DC, Clark GM (1994) Breast cancer outcome and predictors of outcome: are there age differentials? J Natl Cancer Inst Monogr 3:5–42

    Google Scholar 

  19. Yu KD, Di GH, Wu J, Lu JS, Shen KW, Shen ZZ, Shao ZM (2007) Development and trends of surgical modalities for breast cancer in China: a review of 16-year data. Ann Surg Oncol 14:2502–2509

    Article  PubMed  Google Scholar 

  20. Aebi S, Gelber S, Castiglione-Gertsch M, Gelber RD, Collins J, Thurlimann B, Rudenstam CM, Lindtner J, Crivellari D, Cortes-Funes H, Simoncini E, Werner ID, Coates AS, Goldhirsch A (2000) Is chemotherapy alone adequate for young women with oestrogen-receptor-positive breast cancer? Lancet 355:1869–1874

    Article  CAS  PubMed  Google Scholar 

  21. Colleoni M, Rotmensz N, Robertson C, Orlando L, Viale G, Renne G, Luini A, Veronesi P, Intra M, Orecchia R, Catalano G, Galimberti V, Nole F, Martinelli G, Goldhirsch A (2002) Very young women (<35 years) with operable breast cancer: features of disease at presentation. Ann Oncol 13:273–279

    Article  CAS  PubMed  Google Scholar 

  22. Han W, Kim SW, Park IA, Kang D, Youn YK, Oh SK, Choe KJ, Noh DY (2004) Young age: an independent risk factor for disease-free survival in women with operable breast cancer. BMC Cancer 4:82

    Article  PubMed  Google Scholar 

  23. Goldhirsch A, Wood WC, Gelber RD, Coates AS, Thurlimann B, Senn HJ (2007) Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007. Ann Oncol 18:1133–1144

    Article  CAS  PubMed  Google Scholar 

  24. de la Rochefordiere A, Asselain B, Campana F, Scholl SM, Fenton J, Vilcoq JR, Durand JC, Pouillart P, Magdelenat H, Fourquet A (1993) Age as prognostic factor in premenopausal breast carcinoma. Lancet 341:1039–1043

    Article  Google Scholar 

  25. Bonnier P, Romain S, Charpin C, Lejeune C, Tubiana N, Martin PM, Piana L (1995) Age as a prognostic factor in breast cancer: relationship to pathologic and biologic features. Int J Cancer 62:138–144

    Article  CAS  PubMed  Google Scholar 

  26. Love RR, Duc NB, Dinh NV, Quy TT, Xin Y, Havighurst TC (2002) Young age as an adverse prognostic factor in premenopausal women with operable breast cancer. Clin Breast Cancer 2:294–298

    Article  PubMed  Google Scholar 

  27. Kroman N, Jensen MB, Wohlfahrt J, Mouridsen HT, Andersen PK, Melbye M (2000) Factors influencing the effect of age on prognosis in breast cancer: population based study. BMJ 320:474–478

    Article  CAS  PubMed  Google Scholar 

  28. van‘t Veer LI, Dai H, van de Vijver MJ, He YD, Hart AA, Mao M, Peterse HL, van der Kooy K, Marton MJ, Witteveen AT, Schreiber GJ, Kerkhoven RM, Roberts C, Linsley PS, Bernards R, Friend SH (2002) Gene expression profiling predicts clinical outcome of breast cancer. Nature 415:530–536

    Article  Google Scholar 

  29. Klauber-DeMore N (2005) Tumor biology of breast cancer in young women. Breast Dis 23:9–15

    PubMed  Google Scholar 

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Acknowledgments

The authors thank the patients for their willingness to cooperate with our study. This research was supported in part by the grants from the Shanghai Science and Technology Committee (06DJ14004, 06DZ19504).

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Authors and Affiliations

  1. Department of Oncology, Shanghai Medical College, Breast Cancer Institute, Cancer Hospital/Cancer Institute, Fudan University, 270 Dong’an Road, 200032, Shanghai, People’s Republic of China

    Li-Chen Tang, Wen-Jin Yin, Gen-Hong Di, Zhen-Zhou Shen & Zhi-Ming Shao

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  1. Li-Chen Tang
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  2. Wen-Jin Yin
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  3. Gen-Hong Di
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Correspondence to Gen-Hong Di.

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The co-authors Li-Chen Tang and Wen-Jin Yin have contributed equally to the work.

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Tang, LC., Yin, WJ., Di, GH. et al. Unfavourable clinicopathologic features and low response rate to systemic adjuvant therapy: results with regard to poor survival in young Chinese breast cancer patients. Breast Cancer Res Treat 122, 95–104 (2010). https://doi.org/10.1007/s10549-009-0537-4

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  • DOI: https://doi.org/10.1007/s10549-009-0537-4

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