Rath Sushmita, Trikha Mehak, Sarkar Laboni, Jobanputra Kunal, Pawar Akash, Krishnamurthy Revathy, Sahay Ayushi, Sahay Ayushi, Thakkar Purvi, Shah Sneha, Kapu Venkatesh, Sekar Anbarasan, Bhargava Prabhat, Gulia Seema, Pathak Rima, Wadasadawala Tabassum, Sarin Rajiv, Badwe Rajendra, Gupta Sudeep, Bajpai Jyoti
Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute (HBNI), Mumbai, India.
Authors contributed equally to the work.
Ecancermedicalscience. 2025 Jun 24;19:1932. doi: 10.3332/ecancer.2025.1932. eCollection 2025.
Denovo metastatic young breast cancer (dnmYBC), defined as age <40 years, is a challenging entity, with a significant burden and sparse data from low and middle-income countries.
We analysed the prospectively collected data of dnmYBC women from 2015 to 2016.
There were 188 dnmYBC with a median age of 35.5 years. Of these, hormone receptor positive (HR+) were 72 (38.3) %, triple-negatives (TNBC) were 45 (23.9) %, Human Epidermal Growth Factor Positive (HER2+) were 42 (22.4) % and triple positives were 29 (15.4) %. TNBC women predominantly had visceral 40 (88.9%) metastasis, HR+ had nodal 51 (70.8%) and skeletal 10 (13.8%), while HER2+ women had higher brain metastasis (BM) 16 (38.1%).At a median follow-up of 39.8 [Interquartile range (IQR): 24-55.5] months, the median event-free survival (EFS) was 9.3 (95% CI; 8.1-10.4) months for the entire cohort and 1-year, 2-year and 3-year predicted EFS were 47.8%, 13.4% and 3%, respectively. The median EFS was superior in HR+ women.[15.7 months, hormone receptor (HR)-0.53;95% CI-9.8-21.7; p-0.013] versus (11.4 months, 95 %CI-5.9-16.8) in TNBC versus (7.7 months, 95% CI-6.0-9.5) in HER-2 + women and without BM at baseline [9.3 versus 3.0 months (with BM), HR-5.65; CI-1.72-17.9; -0.001]. Median EFS was superior in the treatment-naïve (155, 82.4%) versus prior-treated (33, 17.5%) women, 35.5 (95% CI:12.24-58.72) versus 12.4 (95% CI:11.45-13.51) months; -0.000]. The HER2+ women who received targeted therapy in the first line had a significantly superior median EFS of 13.0 versus 7.7 months (HR -0.465:CI 0.22-0.57: -0.038).
Denovo mYBC is associated with an aggressive course, poor prognosticators include HR negative disease, brain metastasis, inadvertent prior treatment and inadequate access to targeted therapies. Early diagnosis, prompt treatment and expanding accessibility are warranted to improve care.
新发转移性年轻乳腺癌（dnmYBC）定义为年龄<40岁，是一个具有挑战性的疾病实体，负担沉重且来自低收入和中等收入国家的数据稀少。
我们分析了2015年至2016年前瞻性收集的dnmYBC女性的数据。
共有188例dnmYBC患者，中位年龄为35.5岁。其中，激素受体阳性（HR+）者72例（38.3%），三阴性（TNBC）者45例（23.9%），人表皮生长因子阳性（HER2+）者42例（22.4%），三阳性者29例（15.4%）。TNBC女性主要发生内脏转移40例（88.9%），HR+患者发生淋巴结转移51例（70.8%）和骨转移10例（13.8%），而HER2+女性脑转移（BM）发生率较高，为16例（38.1%）。中位随访39.8[四分位间距（IQR）：24 - 55.5]个月，整个队列的中位无事件生存期（EFS）为9.3（95%CI；8.1 - 10.4）个月，1年、2年和3年预测EFS分别为47.8%、13.4%和3%。HR+女性的中位EFS更长。[15.7个月，激素受体（HR）-0.53；95%CI - 9.8 - 21.7；p - 0.013]，TNBC为（11.4个月，95%CI - （此处原文有误，应为95%CI - 5.9 - 16.8）），HER-2 +女性为（7.7个月，95%CI - 6.0 - 9.5），且基线时无BM者[9.3个月对3.0个月（有BM），HR - 5.65；CI - 1.72 - 17.9；p - 0.001]。初治（155例，82.4%）女性的中位EFS优于既往接受过治疗（33例，17.5%）的女性，分别为35.5（95%CI：12.24 - 58.72）个月对12.4（95%CI：11.45 - 13.51）个月；p - 0.000]。一线接受靶向治疗的HER2+女性的中位EFS显著更长，为13.0个月对7.7个月（HR - 0.465：CI 0.22 - 0.57：p - 0.038）。
新发mYBC病程侵袭性强，预后不良因素包括HR阴性疾病、脑转移、既往不经意的治疗以及难以获得靶向治疗。需要早期诊断、及时治疗并扩大可及性以改善治疗效果。
