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Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer

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Abstract

Prior studies have suggested a higher prevalence of high grade, ER-negative, HER2-positive, and basal-like carcinomas in young women with breast cancer. However, the precise distribution of poor prognostic features in this population remains unclear. We examined the pathologic features and distribution of molecular phenotype in relation to patient age in a large group of young women (≤40 years) with invasive breast cancer. Medical records were reviewed for clinical characteristics, tumor stage, and receptor status. Pathologic features, including those features associated with basal-like carcinomas, were examined by central review. Using tumor grade and biomarker expression, cancers were categorized as luminal A (ER+ and/or PR+ and HER2−, histologic grade 1 or 2); luminal B (ER+ and/or PR+ and HER2+, or ER and/or PR+, HER2− and grade 3); HER2 (ER and PR− and HER2+); and triple negative (ER−, PR−, and HER2−). Among 399 women of ≤40 years, 33% had luminal A tumors, 35% luminal B, 11% HER2 (ER-negative), and 21% triple negative. Compared to published results for all breast cancers, a greater proportion of young women had luminal B tumors, and a lesser proportion had luminal A. There were no significant differences in molecular phenotype, tumor stage or grade among the different age groups of young women. However, this population of young women presented with a different distribution of molecular phenotypes compared to the general population of women with breast cancer. These findings may have implications with regard to the etiology and prognosis of breast cancer in young women.

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References

  1. Fisher ER, Anderson S, Tan-Chiu E, Fisher B, Eaton L, Wolmark N (2001) Fifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06. Cancer 91(8 Suppl):1679–1687

    Article  PubMed  CAS  Google Scholar 

  2. Gajdos C, Tartter PI, Bleiweiss IJ, Bodian C, Brower ST (2000) Stage 0 to stage III breast cancer in young women. J Am Coll Surg 190(5):523–529

    Article  PubMed  CAS  Google Scholar 

  3. Han W, Kim SW, Park IA, Kang D, Youn YK, Oh SK et al (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 

  4. 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(7233):474–478

    Article  PubMed  CAS  Google Scholar 

  5. Rapiti E, Fioretta G, Verkooijen HM, Vlastos G, Schafer P, Sappino AP et al (2005) Survival of young and older breast cancer patients in Geneva from 1990 to 2001. Eur J Cancer 41(10):1446–1452

    Article  PubMed  Google Scholar 

  6. Adami HO, Malker B, Holmberg L, Persson I, Stone B (1986) The relation between survival and age at diagnosis in breast cancer. N Engl J Med 315(9):559–563

    Article  PubMed  CAS  Google Scholar 

  7. Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y 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(20):3324–3330

    Article  PubMed  Google Scholar 

  8. Ahn SH, Son BH, Kim SW, Kim SI, Jeong J, Ko SS et al (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(17):2360–2368

    Article  PubMed  Google Scholar 

  9. Colleoni M, Rotmensz N, Robertson C, Orlando L, Viale G, Renne G et al (2002) Very young women (<35 years) with operable breast cancer: features of disease at presentation. Ann Oncol 13(2):273–279

    Article  PubMed  CAS  Google Scholar 

  10. Anders CK, Fan C, Parker JS, Carey LA, Blackwell KL, Klauber-DeMore N et al (2011) Breast carcinomas arising at a young age: Unique biology or a surrogate for aggressive intrinsic subtypes? J Clin Oncol 29(1):e18–e20

    Article  PubMed  Google Scholar 

  11. Perou CM, Jeffrey SS, van de Rijn M, Rees CA, Eisen MB, Ross DT et al (1999) Distinctive gene expression patterns in human mammary epithelial cells and breast cancers. Proc Natl Acad Sci USA 96(16):9212–9217

    Article  PubMed  CAS  Google Scholar 

  12. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98(19):10869–10874

    Article  PubMed  CAS  Google Scholar 

  13. Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A et al (2003) Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA 100(14):8418–8423

    Article  PubMed  CAS  Google Scholar 

  14. Brenton JD, Carey LA, Ahmed AA, Caldas C (2005) Molecular classification and molecular forecasting of breast cancer: Ready for clinical application? J Clin Oncol 23(29):7350–7360

    Article  PubMed  CAS  Google Scholar 

  15. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752

    Article  PubMed  CAS  Google Scholar 

  16. Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K et al (2006) Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. Jama 295(21):2492–2502

    Article  PubMed  CAS  Google Scholar 

  17. Carvalho FM, Bacchi LM, Santos PP, Bacchi CE (2010) Triple-negative breast carcinomas are a heterogeneous entity that differs between young and old patients. Clinics (Sao Paulo) 65(10):1033–1036

    Article  Google Scholar 

  18. Alvarado-Cabrero IV-CR, Barroso-Bravo S (2011) Breast cancer in Mexican women younger than age 45 years. A clinicopathologic study of 1, 320 cases. Mod Pathol 24:26A

    Article  Google Scholar 

  19. Epstein R (1992) Analysis of natural history of breast cancer in young women. Lancet 340(8830):1287

    Article  PubMed  CAS  Google Scholar 

  20. Solin LJ, Fowble B, Schultz DJ, Goodman RL (1989) Age as a prognostic factor for patients treated with definitive irradiation for early stage breast cancer. Int J Radiat Oncol Biol Phys 16(2):373–381

    Article  PubMed  CAS  Google Scholar 

  21. Ogston KN, Miller ID, Payne S, Hutcheon AW, Sarkar TK, Smith I et al (2003) A new histological grading system to assess response of breast cancers to primary chemotherapy: prognostic significance and survival. Breast 12(5):320–327

    Article  PubMed  Google Scholar 

  22. Cheang MC, Voduc D, Bajdik C, Leung S, McKinney S, Chia SK et al (2008) Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Clin Cancer Res 14(5):1368–1376

    Article  PubMed  CAS  Google Scholar 

  23. Cheang MCU, Chia SK, Voduc D, Gao D, Leung S, Snider J, Watson M, Davies S, Bernard PS, Parker JS, Perous CM, Ellis MJ, Nielsen TO (2009) Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 101(10):736–750

    Article  PubMed  CAS  Google Scholar 

  24. Tamimi RM, Baer HJ, Marotti J, Galan M, Galaburda L, Fu Y et al (2008) Comparison of molecular phenotypes of ductal carcinoma in situ and invasive breast cancer. Breast Cancer Res 10(4):R67

    Article  PubMed  Google Scholar 

  25. Yang XR, Sherman ME, Rimm DL, Lissowska J, Brinton LA, Peplonska B et al (2007) Differences in risk factors for breast cancer molecular subtypes in a population-based study. Cancer Epidemiol Biomarkers Prev 16(3):439–443

    Article  PubMed  CAS  Google Scholar 

  26. Nielsen TO, Hsu FD, Jensen K, Cheang M, Karaca G, Hu Z et al (2004) Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res 10(16):5367–5374

    Article  PubMed  CAS  Google Scholar 

  27. 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(1):109–113

    Article  PubMed  Google Scholar 

  28. O’Brien KM, Cole SR, Tse CK, Perou CM, Carey LA, Foulkes WD et al (2010) Intrinsic breast tumor subtypes, race, and long-term survival in the Carolina Breast Cancer Study. Clin Cancer Res 16(24):6100–6110

    Article  PubMed  Google Scholar 

  29. Caldarella A, Crocetti E, Bianchi S, Vezzosi V, Urso C, Biancalani M et al (2011) Female breast cancer status according to ER, PR and HER2 expression: a population based analysis. Pathol Oncol Res 17(3):753–758

    Article  PubMed  CAS  Google Scholar 

  30. Montagna E, Bagnardi V, Rotmensz N, Viale G, Renne G, Cancello G, et al. (2011) Breast cancer subtypes and outcome after local and regional relapse. Ann Oncol. doi:10.1093/annonc/mdr129

  31. Bacchi LM, Corpa M, Santos PP, Bacchi CE, Carvalho FM (2010) Estrogen receptor-positive breast carcinomas in younger women are different from those of older women: a pathological and immunohistochemical study. Breast 19(2):137–141

    Article  PubMed  CAS  Google Scholar 

  32. Livasy CA, Karaca G, Nanda R, Tretiakova MS, Olopade OI, Moore DT et al (2006) Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma. Mod Pathol 19(2):264–271

    Article  PubMed  CAS  Google Scholar 

  33. Rakha EA, El-Sayed ME, Green AR, Lee AH, Robertson JF, Ellis IO (2007) Prognostic markers in triple-negative breast cancer. Cancer 109(1):25–32

    Article  PubMed  CAS  Google Scholar 

  34. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA et al (2007) Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13(15 Pt 1):4429–4434

    Article  PubMed  Google Scholar 

  35. Collins LC, Marotti JD, Baer HJ, Tamimi RM (2008) Comparison of estrogen receptor results from pathology reports with results from central laboratory testing. J Natl Cancer Inst 100(3):218–221

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, USA

    L. C. Collins & S. E. Come

  2. Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA

    J. D. Marotti

  3. Dartmouth Medical School, Hanover, NH, USA

    J. D. Marotti

  4. Dana-Farber Cancer Institute, Boston, MA, USA

    S. Gelber, K. Ruddy, S. Kereakoglow, E. P. Winer & A. H. Partridge

  5. Harvard Medical School, Boston, MA, USA

    L. C. Collins, K. Ruddy, E. F. Brachtel, L. Schapira, S. E. Come, E. P. Winer & A. H. Partridge

  6. Metrowest Medical Center, Framingham, MA, USA

    K. Cole

  7. Massachusetts General Hospital, Boston, MA, USA

    E. F. Brachtel & L. Schapira

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  1. L. C. Collins
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  2. J. D. Marotti
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  3. S. Gelber
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  4. K. Cole
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  7. E. F. Brachtel
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  9. S. E. Come
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Correspondence to L. C. Collins.

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Collins, L.C., Marotti, J.D., Gelber, S. et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat 131, 1061–1066 (2012). https://doi.org/10.1007/s10549-011-1872-9

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  • DOI: https://doi.org/10.1007/s10549-011-1872-9

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