Mathew Aleyamma, Pandey Manoj, Rajan Balakrishnan
Division of Epidemiology and Clinical Research, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
World J Surg Oncol. 2004 Jan 22;2:2. doi: 10.1186/1477-7819-2-2.
Controversy abounds over whether breast cancer in younger women is more aggressive than those in older. The aim of the study was to assess the influence of age on long-term survival of women with breast carcinoma.
Patients with non-metastatic and non-inflammatory invasive breast carcinoma treated at the Regional Cancer Centre, Trivandrum, Kerala, India during 1990-93 were divided into 4 age groups as < 40 years, 40-49, 50-59, and > 60 years. The overall survival (OS) for each age group was estimated using the Kaplan-Meier method in relation to the primary tumor (T) and the axillary node status (N). The OS of the various age groups were compared using the log-rank test. Hazard ratio and 95% confidence interval for each age group was estimated using Cox-regression model after adjusting for T and N.
Between 1990-1993, 1701 women (26%, <40 years) reported with non-metastatic and non-inflammatory invasive breast carcinoma. Overall survival (OS) of all the women was 52.6 % (standard error 1%) at 10 years. The OS for women with age < 40 years and with T3 and T4 disease status was 36.6% and 10.4% respectively and for those in 40-49 age group was 41.9% and 33.5%. The 10-year OS for women with node positive (N1) disease was 24.6% in < 40 years and 45.2% in the 40-49 age group (p = 0.0006). After adjusting for tumor and node stage the relative risk for death was 24% lower for women in 40-49 age group as compared to women <40 years of age.
Women under 40 years with T3/ T4 breast lesions and/or positive axillary nodes were found to have a significantly poorer survival.
关于年轻女性乳腺癌是否比老年女性的更具侵袭性，存在诸多争议。本研究的目的是评估年龄对乳腺癌女性长期生存的影响。
1990 - 1993年期间在印度喀拉拉邦特里凡得琅地区癌症中心接受治疗的非转移性、非炎性浸润性乳腺癌患者被分为4个年龄组：<40岁、40 - 49岁、50 - 59岁和>60岁。使用Kaplan - Meier方法根据原发肿瘤（T）和腋窝淋巴结状态（N）估计每个年龄组的总生存期（OS）。使用对数秩检验比较各年龄组的OS。在对T和N进行校正后，使用Cox回归模型估计每个年龄组的风险比和95%置信区间。
1990 - 1993年间，1701名女性（26%，<40岁）报告患有非转移性、非炎性浸润性乳腺癌。所有女性的10年总生存期（OS）为52.6%（标准误1%）。年龄<40岁且疾病状态为T3和T4的女性的OS分别为36.6%和10.4%，40 - 49岁年龄组的女性分别为41.9%和33.5%。淋巴结阳性（N1）疾病女性的10年OS在<40岁组为24.6%，在40 - 49岁年龄组为45.2%（p = 0.0006）。在对肿瘤和淋巴结分期进行校正后，40 - 49岁年龄组女性的死亡相对风险比<40岁的女性低24%。
发现年龄<40岁且患有T3/T4乳腺病变和/或腋窝淋巴结阳性的女性生存情况明显较差。
