Universitätsfrauenklinik Ulm, Prittwitzstrasse 43, 89075, Ulm, Germany.
Arch Gynecol Obstet. 2010 Oct;282(4):427-32. doi: 10.1007/s00404-009-1339-y. Epub 2010 Jan 3.
The objective of this study was to show differences between breast cancer patients < or =35 and >35 years with regard to tumor characteristics and to present the patient-relevant outcomes overall survival (OAS) and recurrence-free survival (RFS).
We analyzed data from 119 women aged 35 years or younger with breast cancer and compared multiple parameters against breast cancer patients between 36 and 55 (n = 1,097), all pre-menopausal. Data were adjusted for tumor characteristics and therapy.
There was no statistically significant difference in tumor size, axillary lymph node involvement, and histological subtypes. On the contrary, grading lymphovascular invasion and receptor negativity showed statistically significant differences. Unadjusted hazard ratio are 2.11 (1.32-3.39) (OAS) and 1.92 (1.35-2.73) (RFS). Multi-adjusted hazard ratio are 2.97 (1.70-5.18) (OAS) and 2.11 (1.42-3.13) (RFS).
In conclusion, young breast cancer patients still have a poor prognosis. Even after adjustment of the data, OAS and RFS showed a worse prognosis. Normal prognostic factors like tumor size, axillary lymph node involvement, and grading can therefore be not the explanation for the more aggressive disease progress within early onset breast cancer patients.
本研究旨在比较 35 岁及以下和 35 岁以上乳腺癌患者的肿瘤特征，并报告总生存（OAS）和无复发生存（RFS）等与患者相关的结局。
我们分析了 119 例年龄在 35 岁及以下的乳腺癌患者的数据，并将多个参数与 36-55 岁（n=1097）的绝经前乳腺癌患者进行比较。数据根据肿瘤特征和治疗进行了调整。
肿瘤大小、腋窝淋巴结受累和组织学亚型无统计学显著差异。相反，分级淋巴管侵犯和受体阴性显示出统计学显著差异。未经调整的危险比分别为 2.11（1.32-3.39）（OAS）和 1.92（1.35-2.73）（RFS）。多因素调整后的危险比分别为 2.97（1.70-5.18）（OAS）和 2.11（1.42-3.13）（RFS）。
总之，年轻的乳腺癌患者预后仍然较差。即使在调整数据后，OAS 和 RFS 仍显示出更差的预后。因此，肿瘤大小、腋窝淋巴结受累和分级等正常预后因素可能不是早期乳腺癌患者疾病进展更具侵袭性的原因。
