Rudra Soumon, Yu David S, Yu Esther S, Switchenko Jeffrey M, Mister Donna, Torres Mylin A
Department of Radiation Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322, USA.
Int J Breast Cancer. 2015;2015:213123. doi: 10.1155/2015/213123. Epub 2015 Apr 9.
Objective. This study examined recurrence patterns in breast cancer patients younger than age of 40 and older than age of 75, two groups that are underrepresented in clinical trials and not routinely screened by mammography. Methods. The records of 230 breast cancer patients (n = 125 less than 40 and n = 105 greater than 75) who presented to the Emory University Department of Radiation Oncology for curative treatment between 1997 and 2010 were reviewed. Data recorded included disease presentation, treatment, and areas of locoregional recurrence. Results. Women less than 40 years of age had higher rates of locoregional recurrence (20% versus 7%, P = 0.004) and distant recurrence (18% versus 5%, P = 0.003) than patients above 75 years of age. On multivariate analysis, patient age less than 40 was the only significant predictor of locoregional recurrence (P = 0.018). In a univariate analysis of each age group, receptor status and postlumpectomy radiation were significant predictors of locoregional recurrence-free survival in younger women while mammography screening predicted for distant recurrence-free survival in older patients. Conclusion. The factors identified in our age-stratified analysis highlight patients who are at high risk of locoregional and distant recurrence. Future studies aimed at enhancing therapies in young patients are warranted.
目的。本研究调查了年龄小于40岁和大于75岁的乳腺癌患者的复发模式，这两组患者在临床试验中代表性不足，且未常规接受乳腺钼靶筛查。方法。回顾了1997年至2010年间到埃默里大学放射肿瘤学系接受根治性治疗的230例乳腺癌患者的记录（n = 125例年龄小于40岁，n = 105例年龄大于75岁）。记录的数据包括疾病表现、治疗情况以及局部区域复发部位。结果。年龄小于40岁的女性局部区域复发率（20%对7%，P = 0.004）和远处复发率（18%对5%，P = 0.003）高于75岁以上的患者。多因素分析显示，年龄小于40岁是局部区域复发的唯一显著预测因素（P = 0.018）。在对每个年龄组的单因素分析中，受体状态和保乳术后放疗是年轻女性局部区域无复发生存的显著预测因素，而乳腺钼靶筛查则是老年患者远处无复发生存的预测因素。结论。我们在年龄分层分析中确定的因素突出了局部区域和远处复发高风险的患者。有必要开展未来研究以加强对年轻患者的治疗。
