Yang Hua, Wang Si-Yu, Ou Wei, Sun Hai-Bo, Fang Qin
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2009 Dec;28(12):1310-6. doi: 10.5732/cjc.009.10230.
Even though most breast cancers occur in postmenopausal women in western countries, age <35 is one of the prognostic factors. This study was to compare the clinicopathologic characteristics and prognosis between premenopausal breast cancer patients aged of <35 and > or =35 in south China, and to explore the prognostic factors.
A total of 905 consecutive premenopausal patients were evaluated, with first diagnosis of breast cancer referred to surgery at the Sun Yat-sen University Cancer Center from October 2003 to December 2006. The clinicopathologic factors and the survival rates between the very young group(aged of <35 at diagnosis) and the non-young group(aged of > or =35 at diagnosis) were retrospectively compared.
The overall median follow-up time was 27.77 months. The 3-year disease-free survival rate was significantly lower (78.0% vs. 89.1%, P<0.001) and the 3-year survival rate relatively lower(94.3% vs. 96.8%, P=0.10) in the very young group than in the non-young group. In addition, the 3-year survival and disease-free survival rates were significantly lower in the very young group with HR (hormone receptor)-positive than in the non-young group (P<0.05). The univariate and multivariate analysis of clinicopathologic characteristics between two groups showed that age <35 at diagnosis, axillary lymph node involvement, presence of vascular invasion, and high expression of Ki67 were risk factors for recurrence.
Compared with non-young premenopausal patients, very young breast patients with HR-positive cancer have a worse outcome.
尽管西方国家大多数乳腺癌发生在绝经后女性中,但年龄<35岁是预后因素之一。本研究旨在比较中国南方绝经前年龄<35岁和≥35岁的乳腺癌患者的临床病理特征及预后,并探讨预后因素。
对2003年10月至2006年12月在中山大学肿瘤防治中心首次诊断为乳腺癌并接受手术治疗的905例连续绝经前患者进行评估。回顾性比较极年轻组(诊断时年龄<35岁)和非极年轻组(诊断时年龄≥35岁)的临床病理因素及生存率。
总体中位随访时间为27.77个月。极年轻组的3年无病生存率显著低于非极年轻组(78.0%对89.1%,P<0.001),3年生存率相对较低(94.3%对96.8%,P=0.10)。此外,激素受体(HR)阳性的极年轻组3年生存率和无病生存率显著低于非极年轻组(P<0.05)。两组临床病理特征的单因素和多因素分析显示,诊断时年龄<35岁、腋窝淋巴结受累、存在血管侵犯以及Ki67高表达是复发的危险因素。
与非极年轻的绝经前患者相比,HR阳性的极年轻乳腺癌患者预后较差。