De Lima Vazquez Fabiana, Silva Thiago Buosi, Da Costa Vieira René Aloísio, Da Costa Allini Mafra, Scapulatempo Cristovam, Fregnani José Humberto Tavares Guerreiro, Mauad Edmundo Carvalho, Longatto Adhemar, Syrjänen Kari Juhani
Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil; Department of Prevention, Faculty of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
Oncol Lett. 2016 Dec;12(6):4911-4924. doi: 10.3892/ol.2016.5360. Epub 2016 Nov 7.
Invasive breast cancer (BC) is infrequent among women aged ≤40 years, however, the disease outlook in these younger patients is generally worse than among older women. The present study aimed to compare socio-demographic, clinical and pathological characteristics, and their association with long-term survival, between two random cohorts of young (≤40 years) and older (50-69 years) Brazilian patients with BC. The cohort comprised of 738 randomly selected women who were diagnosed with BC at Barretos Cancer Hospital, Pio XII Foundation (Barretos, Brazil) between January 1985 and December 2002; the patients included young women (n=376) and older women (n=362). The current analysis suggested that BC in young women is associated with numerous pathological features of aggressiveness. Second cancer and bilateral BC were independent predictors of a poor outcome in the younger group. Furthermore, C-erB-2 was positively correlated with poor outcome in the older group, whereas estrogen receptor status and TNM stage were associated with disease prognosis in both groups. The overall survival rates of the two age groups were similar except when analyzed according the treatment period (1997-2002). Although patients aged ≤40 years harbored tumors with more aggressive clinicopathological characteristics, these characteristics were not independent predictors of overall survival. The present study indicates that medical advances associated with prevention of breast cancer may improve screening programs, which may therefore increase early diagnosis and subsequently lower mortality rates.
浸润性乳腺癌（BC）在40岁及以下的女性中并不常见，然而，这些年轻患者的疾病预后通常比老年女性更差。本研究旨在比较巴西两个随机队列的年轻（≤40岁）和老年（50 - 69岁）BC患者的社会人口统计学、临床和病理特征，以及它们与长期生存的关联。该队列由738名随机选择的女性组成，她们于1985年1月至2002年12月期间在皮奥十二世基金会巴雷托斯癌症医院（巴西巴雷托斯）被诊断为BC；患者包括年轻女性（n = 376）和老年女性（n = 362）。目前的分析表明，年轻女性的BC与许多侵袭性病理特征相关。第二原发性癌症和双侧BC是较年轻组预后不良的独立预测因素。此外，C - erB - 2在老年组中与不良预后呈正相关，而雌激素受体状态和TNM分期在两组中均与疾病预后相关。除了根据治疗时期（1997 - 2002年）进行分析外，两个年龄组的总生存率相似。尽管年龄≤40岁的患者所患肿瘤具有更具侵袭性的临床病理特征，但这些特征并非总生存的独立预测因素。本研究表明，与乳腺癌预防相关的医学进展可能会改善筛查项目，从而可能提高早期诊断率并随后降低死亡率。
