Martínez María Teresa, Oltra Sara S, Peña-Chilet María, Alonso Elisa, Hernando Cristina, Burgues Octavio, Chirivella Isabel, Bermejo Begoña, Lluch Ana, Ribas Gloria
Medical Oncology and Hematology Unit, Health Research Institute INCLIVA, Valencia, Spain.
Centre of Networked Biomedical Cancer Research (CIBERONC), Valencia, Spain.
Breast Cancer (Auckl). 2019 Feb 20;13:1178223419828766. doi: 10.1177/1178223419828766. eCollection 2019.
Breast cancer (BC) in very young women (BCVY) is more aggressive than in older women. The purpose of this study was to evaluate the relevance of a range of clinico-pathological factors in the prognosis of BCVY patients.
We retrospectively analyzed 258 patients diagnosed with BCVY at our hospital from 1998 to 2014; the control group comprised 101 older patients with BC. We correlated clinicopathological factors, treatments, relapse and exitus with age and with previously published miRNA expression data.
We identified some significant differences in risk factors between BCVY and older patients. The age at menarche, number of pregnancies, and age at first pregnancy were lower in the BCVY group and had a greater probability of recurrence and death in all cases. Lymph node-positive patients in the BCVY group are associated with a worse prognosis ( .02), an immunohistochemical HER2 subtype, and disease relapse ( .03). Moreover, there was a shorter time between diagnosis and first relapse in BCVY patients compared with controls, and they were more likely to die from the disease ( .002). Finally, from our panel of miRNAs deregulated in BC, reduced miR-30c expression was associated with more aggressive BC in very young patients, lower overall survival, and with axillary lymph node metastases.
Patient age and axillary lymph node status post-surgery are independent and significant predictors of distant disease-free survival, local recurrence-free survival, and overall survival. The HER2 subtype and lower miR-30c expression are related to poor prognosis in lymph node-positive young BC patients.
非常年轻女性的乳腺癌（BCVY）比老年女性的乳腺癌更具侵袭性。本研究的目的是评估一系列临床病理因素对BCVY患者预后的相关性。
我们回顾性分析了1998年至2014年在我院诊断为BCVY的258例患者；对照组包括101例老年BC患者。我们将临床病理因素、治疗、复发和死亡与年龄以及先前发表的miRNA表达数据进行关联。
我们发现BCVY患者与老年患者在危险因素方面存在一些显著差异。BCVY组的初潮年龄、怀孕次数和首次怀孕年龄较低，且在所有情况下复发和死亡的可能性更大。BCVY组淋巴结阳性患者的预后较差（P = 0.02），为免疫组化HER2亚型，且疾病复发（P = 0.03）。此外，与对照组相比，BCVY患者从诊断到首次复发的时间更短，且更有可能死于该疾病（P = 0.002）。最后，在我们的BC中失调的miRNA面板中，miR-30c表达降低与非常年轻患者中更具侵袭性的BC、较低的总生存率以及腋窝淋巴结转移相关。
患者年龄和术后腋窝淋巴结状态是远处无病生存、局部无复发生存和总生存的独立且重要的预测因素。HER2亚型和较低的miR-30c表达与淋巴结阳性年轻BC患者的预后不良有关。
