RELATIONSHIP OF PATIENT AGE TO PATHOLOGICAL FEATURES OF THE TUMOR AND PROGNOSIS FOR PATIENTS WITH STAGE-I OR STAGE-II BREAST-CANCER

被引:430
作者
NIXON, AJ
NEUBERG, D
HAYES, DF
GELMAN, R
CONNOLLY, JL
SCHNITT, S
ABNER, A
RECHT, A
VICINI, F
HARRIS, JR
机构
[1] HARVARD UNIV,BETH ISRAEL HOSP,SCH MED,CTR BREAST EVALUAT,DANA FARBER CANC INST,BOSTON,MA
[2] HARVARD UNIV,BETH ISRAEL HOSP,SCH MED,DEPT PATHOL,BOSTON,MA
[3] HARVARD UNIV,SCH PUBL HLTH,DIV BIOSTAT,BOSTON,MA 02115
[4] WILLIAM BEAUMONT HOSP,DEPT RADIAT ONCOL,ROYAL OAK,MI
关键词
D O I
10.1200/JCO.1994.12.5.888
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: 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. Patients and Methods: 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. Results: 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). Conclusion: 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.
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收藏
页码:888 / 894
页数:7
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