Chung M, Chang H R, Bland K I, Wanebo H J
Department of Surgery, Roger Williams Medical Center, Providence, Rhode Island.
Cancer. 1996 Jan 1;77(1):97-103. doi: 10.1002/(SICI)1097-0142(19960101)77:1<97::AID-CNCR16>3.0.CO;2-3.
It is controversial whether breast cancer in young women is more aggressive than in older women. This study was initiated to determine age-associated outcome of women with breast carcinoma.
Patients with breast carcinoma, who were identified in a statewide tumor registry, were divided into age groups based on 10-year intervals (ages 40 and younger, 41 to 50, 51 to 60, 61 to 70, 71 to 80, and older than 80 years). Age at diagnosis, American Joint Committee on Cancer classification, 5-year disease free (5DFS) and cancer specific (5CSS) survival estimates using Kaplan-Meier analysis were determined.
Between 1985 and 1992, 3722 women were diagnosed with invasive breast carcinoma. Approximately 5.6% (210) of the women were 40 years old or younger. The youngest age group had the worst 5CSS of 69.7%, followed by the oldest age group (> 80, 5CSS = 71.45%). The age groups 41 to 50, 51 to 60, 61 to 70, and 71 to 80 years had 5CSS of 80.30%, 78.45%, 82.06%, and 84.27%, respectively. The oldest age group (> 80) had the worst 5DFS (39.88%) followed by the youngest age group (< or = 40, 5DFS = 60.79%). The age groups 41 to 50, 51 to 60, 61 to 70, and 71 to 80 years had 5DFSs of 73.22%, 66.87%, 71.53%, and 63.11%, respectively. Analyzed by stage, young (< or = 40 years) women had a worse 5CSS when compared with the other age groups, except for those with Stage I disease.
Our results indicate that women 40 years of age and younger have a worse 5CSS than their older counterparts. This difference in survival is not solely a reflection of more advanced disease but may reflect differences in tumor biology.
年轻女性乳腺癌是否比老年女性更具侵袭性存在争议。本研究旨在确定乳腺癌女性患者与年龄相关的预后情况。
在全州肿瘤登记处识别出的乳腺癌患者，按10年间隔分为不同年龄组（40岁及以下、41至50岁、51至60岁、61至70岁、71至80岁以及80岁以上）。确定诊断时的年龄、美国癌症联合委员会分类、采用Kaplan-Meier分析的5年无病生存率（5DFS）和癌症特异性生存率（5CSS）。
1985年至1992年间，3722名女性被诊断为浸润性乳腺癌。约5.6%（210名）女性年龄在40岁及以下。最年轻年龄组的5CSS最差，为69.7%，其次是最年长年龄组（>80岁，5CSS = 71.45%）。41至50岁、51至60岁、61至70岁和71至80岁年龄组的5CSS分别为80.30%、78.45%、82.06%和84.27%。最年长年龄组（>80岁）的5DFS最差（39.88%），其次是最年轻年龄组（≤40岁，5DFS = 60.79%）。41至50岁、51至60岁、61至70岁和71至80岁年龄组的5DFS分别为73.22%、66.87%、71.53%和63.11%。按分期分析，年轻（≤40岁）女性除I期疾病患者外，与其他年龄组相比5CSS更差。
我们的结果表明，40岁及以下女性的5CSS比年长女性更差。这种生存差异不仅反映了疾病进展程度更高，还可能反映了肿瘤生物学的差异。
