Young Age Is Associated with Increased Locoregional Recurrence in Node-Positive Breast Cancer with Luminal Subtypes

作者：Kim Sang Won; Chun Mison^*; Han Sehwan; Jung Yong Sik; Choi Jin Hyuk; Kang Seok Yun; Yim Hyunee; Kang Seung Hee

来源：Cancer Research and Treatment, 2017, 49(2): 484-493.

DOI：10.4143/crt.2016.246

• Breast neoplasms
• Local neoplasm recurrence
• Age factors

Purpose
The effects of biological subtypes within breast cancer on prognosis are influenced by age at diagnosis. We investigated the association of young age with locoregional recurrence (LRR) between patients with lumina! subtypes versus those with nonluminal subtypes.
Materials and Methods
Medical records of 524 breast cancer patients with positive lymph nodes between 1999 and 2010 were reviewed retrospectively. All patients received curative surgery and adjuvant chemotherapy based on contemporary guidelines. Radiation was delivered for patients who underwent breast conserving surgery or those who had four or more positive lymph nodes after mastectomy. Adjuvant hormone therapy was administered to 413 patients with positive hormone receptors according to their menstrual status.
Results
During median follow-up of 84 months, the 10-year locoregional recurrence-free survival rate (LRRFS) was 84.3% for all patients. Patients < 40 years showed significantly worse 10-year LRRFS than those >= 40 years (73.2% vs. 89.0%, respectively; p=0.01). The negative effect of young age on LRRFS was only observed in luminal subtypes (69.7% for < 40 years vs. 90.8% for >= 40 years; p < 0.01). Multivariate analysis using luminal-subtypes >= 40 years as a reference revealed lumina! subtypes < 40 years were significantly associated with increased risk of LRR (hazard ratio, 2.33; p < 0.01).
Conclusion
Young breast cancer patients with positive lymph nodes had a higher risk of LRR than those aged >= 40 years. This detrimental effect of young age on LRR was confined in luminal subtypes.

• 出版日期2017-4