Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.
Eur J Surg Oncol. 2011 Dec;37(12):1030-7. doi: 10.1016/j.ejso.2011.08.133. Epub 2011 Sep 21.
The purpose was to analyse the characteristics, treatment, recurrences and survival of very young women with breast cancer.
212 female breast cancer patients ≤35 years old were treated during 1997-2007. The median follow-up time was 78 months.
117 patients had lymph node metastases and 14 distant metastases at diagnosis. 81 (38%) tumours were hormone receptor negative and 130 (65%) grade 3. HER2 positivity was seen in 47 (34%) and triple negativity in 35 (26%) of the 137 tumours with known HER2 status. 140 women were treated with mastectomy and 68 with breast conserving surgery. 163 patients received postoperative radiotherapy, 175 adjuvant chemotherapy, 95 endocrine therapy and 18 trastuzumab. 63 patients experienced a recurrence, of which 20 had only a locoregional recurrence. 10 (15%) of the women with breast conserving surgery experienced ipsilateral breast tumour recurrence while ipsilateral thoracic wall recurrence was seen in 8 patients (6%) after mastectomy. Seven of these eight patients did not receive postmastectomy radiotherapy. DFI was shorter in patients with hormone receptor positive tumours. At the end of follow-up 44 women had died. The 5-year OS was 80%.
The 5-year OS for young women has become better but is still lower than for all breast cancer patients. DFI was shorter in patients with hormone receptor positive disease. Locoregional recurrences were seen more often after breast conserving surgery.
分析年轻女性乳腺癌的特征、治疗、复发和生存情况。
1997 年至 2007 年间，治疗了 212 名≤35 岁的女性乳腺癌患者。中位随访时间为 78 个月。
117 例患者在诊断时存在淋巴结转移，14 例存在远处转移。81 例（38%）肿瘤激素受体阴性，130 例（65%）为 3 级。已知 HER2 状态的 137 例肿瘤中，47 例（34%）HER2 阳性，35 例（26%）三阴性。140 例患者接受了乳房切除术，68 例接受了保乳手术。163 例患者接受了术后放疗，175 例接受了辅助化疗，95 例接受了内分泌治疗，18 例接受了曲妥珠单抗治疗。63 例患者复发，其中 20 例仅局部区域复发。10 例（15%）保乳手术后的患者同侧乳房肿瘤复发，8 例（6%）乳房切除术后同侧胸壁复发。这 8 例患者中有 7 例未接受乳房切除术后放疗。激素受体阳性肿瘤患者的 DFI 更短。随访结束时，44 名女性死亡。5 年 OS 为 80%。
年轻女性的 5 年 OS 已经有所改善，但仍低于所有乳腺癌患者。激素受体阳性疾病患者的 DFI 更短。保乳手术后局部区域复发更常见。
