Nixon A J, Neuberg D, Hayes D F, Gelman R, Connolly J L, Schnitt S, Abner A, Recht A, Vicini F, Harris J R
Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA.
J Clin Oncol. 1994 May;12(5):888-94. doi: 10.1200/JCO.1994.12.5.888.
This analysis was performed to clarify the relationship of young age at diagnosis to the pathologic features of the tumor and prognosis in patients with early-stage breast cancer.
We retrospectively analyzed data from 1,398 patients with American Joint Committee on Cancer Staging stage I or II breast cancer treated by breast-conserving therapy between 1968 and 1985. One hundred seven patients were younger than 35 years at the time of diagnosis. The median follow-up duration for the 1,032 survivors was 99 months.
Patients younger than 35 years had a significantly higher overall recurrence rate (P = .002), as well as a greater risk for developing distant metastases (P = .03), when compared with older patients. The cancers in younger patients more commonly showed factors associated with a worse prognosis (including grade 3 histology, lymphatic vessel invasion [LVI], necrosis, and estrogen receptor [ER] negativity) as compared with older patients. In a proportional hazards model that included clinical and treatment-related variables, as well as these pathologic features, age younger than 35 years remained a significant predictor for time to recurrence (relative risk [RR], 1.70), time to distant failure (RR, 1.60), and overall mortality (RR, 1.50).
Breast cancer patients younger than 35 years have a worse prognosis than older patients. This difference is only partially explained by a higher frequency of adverse pathologic factors seen in younger patients.
进行此项分析以阐明早期乳腺癌患者诊断时的年轻年龄与肿瘤病理特征及预后之间的关系。
我们回顾性分析了1968年至1985年间接受保乳治疗的1398例美国癌症联合委员会分期为I期或II期乳腺癌患者的数据。107例患者诊断时年龄小于35岁。1032例幸存者的中位随访时间为99个月。
与年龄较大的患者相比，年龄小于35岁的患者总体复发率显著更高（P = .002），发生远处转移的风险也更高（P = .03）。与年龄较大的患者相比，年轻患者的癌症更常表现出与预后较差相关的因素（包括3级组织学、淋巴管浸润[LVI]、坏死和雌激素受体[ER]阴性）。在一个包含临床和治疗相关变量以及这些病理特征的比例风险模型中，年龄小于35岁仍然是复发时间（相对风险[RR]，1.70）、远处失败时间（RR，1.60）和总死亡率（RR，1.50）的显著预测因素。
年龄小于35岁的乳腺癌患者预后比年龄较大的患者差。这种差异仅部分由年轻患者中不良病理因素的较高频率所解释。
