Annals of Surgical Oncology

, Volume 23, Issue 10, pp 3212–3220 | Cite as

Factors Associated with Recurrence Rates and Long-Term Survival in Women Diagnosed with Breast Cancer Ages 40 and Younger

  • Jennifer K. Plichta
  • Upahvan Rai
  • Rong Tang
  • Suzanne B. Coopey
  • Julliette M. Buckley
  • Michele A. Gadd
  • Michelle C. Specht
  • Kevin S. Hughes
  • Alphonse G. Taghian
  • Barbara L. Smith
Breast Oncology

Abstract

Background

Young age at breast cancer diagnosis has been associated with increased risk of recurrence and mortality. We reevaluated this assumption in a large, modern cohort of women diagnosed with breast cancer at age ≤40 years.

Methods

We identified women with breast cancer at age ≤40 years at a single institution from 1996–2008. We assessed locoregional recurrence (LRR), distant recurrence, disease-free survival (DFS), and overall survival (OS), and correlated patient and tumor characteristics with outcomes.

Results

We identified 584 women aged ≤40 years with breast cancer. Median age was 37 years, and median follow-up was 124 months; 61.5 % were stages 0–I and 38.5 % were stages II–III. Overall, 57.4 % had lumpectomies and 42.5 % mastectomies. DFS was 93 % at 5 years and 84.5 % at 10 years. OS was 93 % at 5 years and 86.5 % at 10 years. On multivariate analysis, worse DFS was associated with positive nodes (p = 0.002); worse OS was associated with larger tumor size (p = 0.042). When stratified by lumpectomy versus mastectomy, there were no significant differences in survival or recurrence. For lumpectomy patients, DFS was 96 % at 5 years and 88 % at 10 years; OS was 96 % at 5 years and 89 % at 10 years. For mastectomy patients, DFS was 89.5 % at 5 years and 79 % at 10 years; OS was 90 % at 5 years and 83 % at 10 years. Lumpectomy LRR rates were 1 % at 5 years and 4 % at 10 years. Mastectomy LRR rates were 3.5 % at 5 years and 8.7 % at 10 years.

Conclusions

Outcomes for women with breast cancer at age ≤40 years have improved. Lumpectomy recurrence rates are low, suggesting that lumpectomy is oncologically safe for young breast cancer patients.

Keywords

Breast Cancer Overall Survival Distant Recurrence Ipsilateral Breast Tumor Recurrence Ipsilateral Breast 

Notes

Disclosure

The authors have no potential conflicts of interest.

Supplementary material

10434_2016_5404_MOESM1_ESM.tif (1.5 mb)
Supplementary material 1 (TIFF 1549 kb) Kaplan-Meier estimates for the entire cohort stratified by (A) tumor grade (log rank test, p=0.039)
10434_2016_5404_MOESM2_ESM.tif (1.5 mb)
Supplementary material 2 (TIFF 1549 kb) Kaplan-Meier estimates for the entire cohort stratified by (B) lymphovascular invasion (log rank test, p<0.001)
10434_2016_5404_MOESM3_ESM.tif (1.5 mb)
Supplementary material 3 (TIFF 1549 kb) Kaplan-Meier estimates for the entire cohort stratified by (C) lymph node status (log rank test, p<0.001)
10434_2016_5404_MOESM4_ESM.tif (1.5 mb)
Supplementary material 4 (TIFF 1549 kb) Kaplan-Meier estimates for the entire cohort stratified by (D) triple negative receptor status (log rank test, p=0.968)
10434_2016_5404_MOESM5_ESM.docx (14 kb)
Supplementary material 5 (DOCX 13 kb) Univariate analyses (by Cox regression) of disease-free survival and overall survival. HR: hazard ratio, 95%CI: 95% confidence interval, LVI: lymphovascular invasion, ER: estrogen receptor, PR: progesterone receptor, HER2: human epidermal growth factor 2

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Jennifer K. Plichta
    • 1
  • Upahvan Rai
    • 1
  • Rong Tang
    • 1
  • Suzanne B. Coopey
    • 1
  • Julliette M. Buckley
    • 1
  • Michele A. Gadd
    • 1
  • Michelle C. Specht
    • 1
  • Kevin S. Hughes
    • 1
  • Alphonse G. Taghian
    • 2
  • Barbara L. Smith
    • 1
    • 2
  1. 1.Division of Surgical Oncology, Department of SurgeryMassachusetts General HospitalBostonUSA
  2. 2.Department of Radiation OncologyMassachusetts General HospitalBostonUSA

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