Kim Sang-Won, Chun Mison, Han Sehwan, Jung Yong Sik, Choi Jin Hyuk, Kang Seok Yun, Yim Hyunee, Kang Seung Hee
Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Cancer Res Treat. 2017 Apr;49(2):484-493. doi: 10.4143/crt.2016.246. Epub 2016 Aug 23.
The effects of biological subtypes within breast cancer on prognosis are influenced by age at diagnosis. We investigated the association of young age with locoregional recurrence (LRR) between patients with luminal subtypes versus those with nonluminal subtypes.
Medical records of 524 breast cancer patients with positive lymph nodes between 1999 and 2010 were reviewed retrospectively. All patients received curative surgery and adjuvant chemotherapy based on contemporary guidelines. Radiation was delivered for patients who underwent breast conserving surgery or those who had four or more positive lymph nodes after mastectomy. Adjuvant hormone therapy was administered to 413 patients with positive hormone receptors according to their menstrual status.
During median follow-up of 84 months, the 10-year locoregional recurrence-free survival rate (LRRFS) was 84.3% for all patients. Patients < 40 years showed significantly worse 10-year LRRFS than those ≥ 40 years (73.2% vs. 89.0%, respectively; p=0.01). The negative effect of young age on LRRFS was only observed in luminal subtypes (69.7% for < 40 years vs. 90.8% for ≥ 40 years; p < 0.01). Multivariate analysis using luminal subtypes ≥ 40 years as a reference revealed luminal subtypes < 40 years were significantly associated with increased risk of LRR (hazard ratio, 2.33; p < 0.01).
Young breast cancer patients with positive lymph nodes had a higher risk of LRR than those aged ≥ 40 years. This detrimental effect of young age on LRR was confined in luminal subtypes.
乳腺癌的生物学亚型对预后的影响受诊断时年龄的影响。我们研究了管腔亚型患者与非管腔亚型患者中年轻与局部区域复发（LRR）之间的关联。
回顾性分析了1999年至2010年间524例淋巴结阳性乳腺癌患者的病历。所有患者均根据当代指南接受了根治性手术和辅助化疗。对接受保乳手术的患者或乳房切除术后有四个或更多阳性淋巴结的患者进行放疗。根据月经状况，对413例激素受体阳性患者给予辅助激素治疗。
在中位随访84个月期间，所有患者的10年局部区域无复发生存率（LRRFS）为84.3%。年龄<40岁的患者10年LRRFS明显低于年龄≥40岁的患者（分别为73.2%和89.0%；p=0.01）。年轻对LRRFS的负面影响仅在管腔亚型中观察到（年龄<40岁的患者为69.7%，年龄≥40岁的患者为90.8%；p<0.01）。以年龄≥40岁的管腔亚型为参照进行多因素分析显示，年龄<40岁的管腔亚型与LRR风险增加显著相关（风险比，2.33；p<0.01）。
淋巴结阳性的年轻乳腺癌患者发生LRR的风险高于年龄≥40岁的患者。年轻对LRR的这种有害影响局限于管腔亚型。
