Very young women (<35 years) with operable breast cancer:: features of disease at presentation

被引:285
作者
Colleoni, M
Rotmensz, N
Robertson, C
Orlando, L
Viale, G
Renne, G
Luini, A
Veronesi, P
Intra, M
Orecchia, R
Catalano, G
Galimberti, V
Nolé, F
Martinelli, G
Goldhirsch, A
机构
[1] European Inst Oncol, Dept Med, I-20141 Milan, Italy
[2] European Inst Oncol, Div Epidemiol & Biostat, I-20141 Milan, Italy
[3] European Inst Oncol, Div Pathol, I-20141 Milan, Italy
[4] Univ Milan, Sch Med, European Inst Oncol, Div Senol, Milan, Italy
[5] Univ Milan, Sch Med, European Inst Oncol, Div Radiotherapy, Milan, Italy
关键词
breast cancer; prognostic features; very young women;
D O I
10.1093/annonc/mdf039
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Breast cancer rarely occurs in young women. Our knowledge about disease presentation, prognosis and treatment effects are largely dependent upon older series. Materials and methods: We evaluated biological features and stage at presentation for 1427 consecutive premenopausal patients aged : 50 years with first diagnosis of invasive breast cancer referred to surgery at the European Institute of Oncology from April 1997 to August 2000. A total of 185 patients (13%) were aged <35 years ('very young') and 1242 (87%) were aged 35-50 years ('less young'). The expression of estrogen receptors (ER), progesterone receptors (PgR), presence of vascular invasion (VI), grading (G), expression of Ki-67, HER2/neu overexpression, pathological stage according to TNM staging system (pTNM), pathological tumor size and number of axillary lymph node involvement were evaluated. Results: Compared with less young patients, the very young patient group had a higher percentage of tumors classified as ER negative (P < 0.001), PgR negative (P = 0.001), higher expression of Ki-67; greater than or equal to20% of cells stained; 62.2% versus 53%, (P < 0.001), vascular or lymphatic invasion (48.6% versus 37.3%, P = 0.006), and pathological grade 3 (P < 0.0001). There was no difference between the two groups for pT, pathological tumor size (pN) and number of positive lymph nodes. Conclusions: We conclude that compared with less young premenopausal patients, very young women have a greater chance of having an endocrine-unresponsive tumor, and are more likely to present with a higher grade, more extensively proliferating and vessel invading disease. Pathological tumor size, nodal status and number of positive axillary lymph-nodes have a similar distribution among the younger and the older cohorts, thus not supporting previous data indicating more advanced disease in younger patients at diagnosis of operable disease.
引用
收藏
页码:273 / 279
页数:7
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