by Ondine Dufour,
Gilles Houvenaeghel, Jean-Marc Classe, Monique Cohen, Christelle Faure, Chafika
Mazouni, Marie-Pierre Chauvet, Eva Jouve, Emile Darai, Anne-Sophie Azuar,
Pierre Gimbergues, Anthony Gonçalves, Alexandre de Nonneville
The Breast: Published: February 08, 2023
Background
There is a scarcity
of data exploring early breast cancer (eBC) in very young patients. We assessed
shared and intrinsic prognostic factors in a large cohort of patients aged ≤35,
compared to a control group aged 36 to 50.
Methods
Patients ≤50 were
retrospectively identified from a multicentric cohort of 23,134 eBC patients
who underwent primary surgery between 1990 and 2014. Multivariate Cox analyses
for DFS and OS were built. To assess the independent impact of age, 1 to 3
case-control analysis was performed by matching ≤35 and 36–50 years patients.
Results
Of 6481 patients,
556 were aged ≤35, and 5925 from 36 to 50. Age ≤35 was associated with larger
tumors, higher grade, ER-negativity, macroscopic lymph node involvement
(pN + macro), lymphovascular invasion (LVI), mastectomy, and
chemotherapy (CT) use. In multivariate analysis, age ≤35 was associated with
worse DFS [HR 1.56, 95% CI 1.32–1.84; p < 0.001], and OS [HR
1.29, 95% CI 1.03–1.60; p = 0.025], as were high grade, large
tumor, LVI, pN + macro, ER-negativity, period of diagnostic, and
absence of ET or CT (for DFS). Adverse prognostic impact of age ≤35 was
maintained in the case control-matched analysis for DFS [HR 1.56, 95%CI
1.28–1.91, p < 0.001], and OS [HR 1.33, 95%CI
1.02–1.73, p = 0.032]. When only considering patients ≤35, ER,
tumor size, nodal status, and LVI were independently associated with survival
in this subgroup.
Conclusions
Age ≤35 is
associated with less favorable presentation and more aggressive treatment
strategies. Our results support the poor prognosis value of young age, which
independently persisted when adjusting for other prognostic factors and
treatments.
