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

• Published in: Breast cancer research and treatment 2010-07, Vol.122 (1), p.95-104
• Main Authors: Tang, Li-Chen, Yin, Wen-Jin, Di, Gen-Hong, Shen, Zhen-Zhou, Shao, Zhi-Ming
• Format: Article
• Language: English
• Subjects: Adjuvant treatment; Adult; Age; Age Factors; Analysis; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Breast cancer; breast neoplasms; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - radiotherapy; Breast Neoplasms - surgery; Cancer; Cancer research; Cancer therapies; Carcinoma - drug therapy; Carcinoma - mortality; Carcinoma - pathology; Carcinoma - radiotherapy; Carcinoma - surgery; Care and treatment; Characteristics; Chemotherapy, Adjuvant; China - epidemiology; Combined Modality Therapy; Disease-Free Survival; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Kaplan-Meier Estimate; Mammary gland diseases; Mastectomy; Medical prognosis; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; mortality; Oncology; Ovariectomy; Patient outcomes; Patient Selection; Preclinical Study; Prognosis; Proportional Hazards Models; Radiotherapy, Adjuvant; therapeutics; Tumors; Young women
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-009-0537-4

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.