Villarreal-Garza Cynthia, Mohar Alejandro, Bargallo-Rocha Juan Enrique, Lasa-Gonsebatt Federico, Reynoso-Noverón Nancy, Matus-Santos Juan, Cabrera Paula, Arce-Salinas Claudia, Lara-Medina Fernando, Alvarado-Miranda Alberto, Ramírez-Ugalde María Teresa, Soto-Perez-de-Celis Enrique
Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico.
Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología e Instituto de Biomédicas, UNAM, Mexico City, Mexico.
Clin Breast Cancer. 2017 Jun;17(3):e95-e102. doi: 10.1016/j.clbc.2016.11.007. Epub 2016 Nov 23.
Young age represents an adverse prognostic factor in breast cancer (BC), and young women present with more advanced and aggressive disease. In Latin America, BC is increasing in young women, and there is a lack of information regarding the characteristics and outcomes of this patient population.
We retrospectively analyzed a database of 4315 women treated for BC at a single institution. We compared clinical characteristics, treatment, and survival between women ≤ 40 and > 40 years of age. Survival analyses were performed for each molecular subtype.
A total of 662 women (15.3%) were ≤ 40 years old. Younger women had more advanced disease, higher grade, and a larger proportion of luminal B and triple-negative tumors (P < .001). At 5 years, both disease-free and overall survival (OS) were lower in younger women, although there were no differences after adjusting for stage. Five-year OS was worse for young women with hormone receptor-positive, human epidermal growth factor receptor 2-negative subtype (82% vs. 87.1%; P = .03), but not for those with human epidermal growth factor receptor 2-positive or triple-negative disease. This difference can be attributed to luminal B tumors, which showed a worse 5-year OS in younger women (79.1% vs. 85.2%; P = .03).
Although young Mexican patients with BC have more aggressive disease at presentation than older women, only those with luminal B tumors have a worse survival after adjusting for stage. Strategies aimed at downstaging the disease and at improving the treatment of luminal B tumors in this population are needed.
年轻是乳腺癌（BC）的不良预后因素，年轻女性患的疾病更晚期且侵袭性更强。在拉丁美洲，年轻女性中的乳腺癌发病率正在上升，而关于这一患者群体的特征和预后缺乏相关信息。
我们回顾性分析了在单一机构接受乳腺癌治疗的4315名女性的数据库。我们比较了年龄≤40岁和＞40岁女性之间的临床特征、治疗情况和生存率。对每种分子亚型进行了生存分析。
共有662名女性（15.3%）年龄≤40岁。年轻女性的疾病更晚期、分级更高，管腔B型和三阴性肿瘤的比例更大（P＜0.001）。5年时，年轻女性的无病生存率和总生存率（OS）均较低，尽管在调整分期后无差异。激素受体阳性、人表皮生长因子受体2阴性亚型的年轻女性5年总生存率较差（82%对87.1%；P = 0.03），但人表皮生长因子受体2阳性或三阴性疾病的年轻女性则不然。这种差异可归因于管腔B型肿瘤，年轻女性的5年总生存率更差（79.1%对85.2%；P = 0.03）。
尽管墨西哥年轻的乳腺癌患者在初诊时比老年女性的疾病侵袭性更强，但只有管腔B型肿瘤的患者在调整分期后生存率较差。需要采取旨在降低疾病分期和改善该人群管腔B型肿瘤治疗的策略。
