Rapiti Elisabetta, Fioretta Gerald, Verkooijen Helena M, Vlastos Georges, Schäfer Peter, Sappino André-Pascal, Kurtz John, Neyroud-Caspar Isabelle, Bouchardy Christine
Geneva Cancer Registry, Institute for Social and Preventive Medicine, University of Geneva, Switzerland.
Eur J Cancer. 2005 Jul;41(10):1446-52. doi: 10.1016/j.ejca.2005.02.029.
The effect of age on breast cancer survival is still a matter of controversy. Breast cancer in young women is thought to be more aggressive and to have worse prognosis but results from clinical research have been neither consistent nor definitive. In this study, we have assessed the impact of young age at diagnosis on tumor characteristics, treatment and survival of breast cancer. The study included 82 very young (< or = 35 years), 790 young (36-49), and 2125 older (50-69) women recorded between 1990 and 2001 at the Geneva Cancer Registry. Very young and young patients had more often stage II cancers (P = 0.009), poorly differentiated (P < 0.001) and estrogen receptor negative (P < 0.001) tumors. They were also more likely to receive chemotherapy (P < 0.001) and less likely to receive hormonal therapy (P < 0.001). Specific five-year survival was not different in the three groups (91%, 90%, and 89% for very young, young and older, respectively). When adjusting for all prognostic variables, age was not significantly related to mortality from breast cancer with a hazard ratio of 0.8 (95% CI: 0.3-2.0) for very young and 1.1 (95% CI: 0.8-1.4) for young patients compared to older women. Tumor stage, differentiation, estrogen receptor status, surgery, and radiotherapy were all independent determinants of breast cancer prognosis. We conclude that age is not an independent prognostic factor when accounting for breast tumor characteristics and treatment.
年龄对乳腺癌生存的影响仍是一个有争议的问题。年轻女性的乳腺癌被认为更具侵袭性，预后更差，但临床研究结果并不一致且尚无定论。在本研究中，我们评估了诊断时年轻对乳腺癌肿瘤特征、治疗及生存的影响。该研究纳入了1990年至2001年间在日内瓦癌症登记处记录的82名极年轻（≤35岁）、790名年轻（36 - 49岁）和2125名年长（50 - 69岁）女性。极年轻和年轻患者更常患有II期癌症（P = 0.009）、低分化肿瘤（P < 0.001）和雌激素受体阴性肿瘤（P < 0.001）。她们接受化疗的可能性也更大（P < 0.001），而接受激素治疗的可能性更小（P < 0.001）。三组的特定五年生存率并无差异（极年轻、年轻和年长组分别为91%、90%和89%）。在对所有预后变量进行调整后，与年长女性相比，极年轻患者的乳腺癌死亡风险比为0.8（95%可信区间：0.3 - 2.0），年轻患者为1.1（95%可信区间：0.8 - 1.4），年龄与乳腺癌死亡率无显著相关性。肿瘤分期、分化程度、雌激素受体状态、手术和放疗都是乳腺癌预后的独立决定因素。我们得出结论，在考虑乳腺肿瘤特征和治疗时，年龄不是一个独立的预后因素。
