Carreiro Karina Belickas, Goncalves Rodrigo, Mota Bruna Salani, Soares José Maria, Baracat Edmund Chada, Filassi José Roberto
Setor de Mastologia da Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Setor de Mastologia da Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Cancer Epidemiol. 2023 Oct;86:102437. doi: 10.1016/j.canep.2023.102437. Epub 2023 Aug 8.
The incidence of breast cancer among women under 41 years old varies worldwide, with higher rates observed in developing countries. These young women often face later-stage diagnoses. In this study, we examine a cohort of young women who were treated for breast cancer in São Paulo, Brazil.
We conducted a retrospective cohort study involving women under 41 years old. Our objective was to describe patient and treatment characteristics, with the main outcomes being overall and disease-free survival. Our analysis explored the associations between age of menarche, history of breastfeeding, use of hormonal contraceptives, and age at diagnosis.
Our study included 493 patients with a mean follow-up of 62.8 months. The mean age of the patients was 34.6 (SD=4.19). Of the patients, 68% presented with locally advanced disease, and 19.27% were metastatic at the time of diagnosis. We observed significant associations between age of menarche and age at diagnosis (p = 0.0096), as well as age at diagnosis and breastfeeding (p = 0.0232). Chemotherapy was administered to 92.91% of the patients as part of their treatment, while 27.2% were eligible for breast-conserving surgery. During the follow-up period, 153 patients died, with disease progression being the cause of death in 73.2% of cases. The median survival time for the entire cohort is still under review, while the metastatic patients at diagnosis had a median survival time of 28.64 months (95%CI 20.21-40.89).
Our findings highlight significant associations between late-stage diagnosis and overall and disease-free survival in this patient age group. Given that the majority of patients present with locally advanced breast cancer, it is crucial to implement strategies that promote early-stage diagnosis and improve survival rates.
41岁以下女性乳腺癌的发病率在全球范围内有所不同,在发展中国家观察到的发病率更高。这些年轻女性往往面临较晚的诊断。在本研究中,我们调查了巴西圣保罗接受乳腺癌治疗的年轻女性队列。
我们进行了一项回顾性队列研究,纳入41岁以下的女性。我们的目标是描述患者和治疗特征,主要结局是总生存期和无病生存期。我们的分析探讨了初潮年龄、母乳喂养史、激素避孕药使用情况与诊断年龄之间的关联。
我们的研究包括493名患者,平均随访62.8个月。患者的平均年龄为34.6岁(标准差=4.19)。其中,68%的患者表现为局部晚期疾病,19.27%在诊断时已发生转移。我们观察到初潮年龄与诊断年龄之间存在显著关联(p = 0.0096),以及诊断年龄与母乳喂养之间存在显著关联(p = 0.0232)。92.91%的患者接受了化疗作为治疗的一部分,而27.2%的患者符合保乳手术条件。在随访期间,153名患者死亡,73.2%的病例死亡原因是疾病进展。整个队列的中位生存时间仍在审查中,而诊断时已转移的患者中位生存时间为28.64个月(95%置信区间20.21 - 40.89)。
我们的研究结果突出了该患者年龄组晚期诊断与总生存期和无病生存期之间的显著关联。鉴于大多数患者表现为局部晚期乳腺癌,实施促进早期诊断和提高生存率的策略至关重要。