Age influences outcome of certain breast cancer subtypes
MedWire News: Very young patients with triple negative, luminal B or human epidermal growth factor receptor (HER)2-positive breast cancer have a worse prognosis than older patients with similar disease characteristics, Italian research shows.
“There is limited knowledge about prognosis of selected breast cancer subtypes among very young women,” explain Giuseppe Cancello (European Institute of Oncology, Milan)
Cancello and team therefore explored patterns of recurrence by age according to four immunohistochemically defined tumor subtypes: luminal A and luminal B (estrogen receptor [ER] positive and/or progesterone receptor [PgR] positive and either human HER2-positive and/or high Ki-67), HER2-positive only, and triple negative.
They studied 2970 premenopausal women with pT1-3, pN0-3 and M0 breast cancer. The women were divided into two groups, those younger than 35 years (n=315, 11%) and those aged 35–50 years.
Compared with older patients, those younger than 35 years of age had a significantly higher prevalence of high-grade tumors (57% vs 34%), ER-positive tumors (23% vs 13%), PgR-positive tumors (32% vs 19%) and HER-2 positive tumors (21% vs 15%).
Overall, the younger patients had a 65% increased risk for recurrence and a 78% increased risk for death when compared with older patients with similar disease characteristics.
The risk for recurrence was a significant 62%, 237% and 204% higher among the younger women with luminal B, HER2-positive and triple negative breast cancer, respectively, compared with older patients. Moreover, younger patients with luminal B and triple negative subtypes had more than double the risk for death compared with older patients (hazard ratio = 2.09 and 2.20, respectively) . In contrast, no significant effect of age was observed in the subgroup of patients with the luminal A subtype.
“The present study indicates that the outcome of very young patients with early breast cancer is worse in selected tumor subtypes identified by immunohistochemistry,” write Cancello and co-authors in the Annals of Oncology.
“Moreover, the results presented in this study support the hypothesis that the progress in the adjuvant treatment of very young patients requires study of tailored treatments in specific ‘niches’ of patients,” they add.
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By Laura Dean