Young Breast Cancer Patients Face Higher Risk of Recurrence

TOPLINE:

A new study suggests that age is an independent risk factor for late distant recurrence in young patients with ER-positive, ERBB2-negative breast cancer. In the analysis, patients aged 21 to 35 years had the lowest rates of locoregional recurrence-free survival, disease-free survival, and late distant metastasis-free survival compared with patients aged 36 to 45 years.

METHODOLOGY:

• Survival outcomes tend to be worse in younger breast cancer patients with ER-positive, ERBB2-negative tumors, but there are limited data on the risk of recurrence in this population, particularly late distant recurrence after 5 years.
• In the current retrospective cohort study, researchers evaluated 2772 patients aged 21 to 45 years with ER-positive, ERBB2-negative breast cancer without distant recurrence within 5 years following surgery.
• Patients were divided into three age groups according to their age at diagnosis: 21-35 years (n=370), 36-40 years (n=885) and 41-45 years (n=1517). Clinicopathological features and oncological outcomes were compared between these groups.
• The primary outcome was late distant recurrence. The average follow-up period was 10.8 years.
• All patients received adjuvant endocrine therapy for at least 2 years; 90% received treatment for 5 years or more, with 10% completing 2-5 years of treatment. A higher proportion of patients in the youngest group (15.9%) had received endocrine therapy for less than 5 years compared to those in the older groups (7.9% in the 36-40 age group and 7.4% in the 41-45 age group).

TAKE AWAY:

• Compared with patients in the two older age groups, the youngest patients (ages 21 to 35) had worse 10-year locoregional relapse-free survival rates (90.1% versus 94.6% for ages 36 to 40 and 97% for ages 41 to 45). ,7). ), disease-free survival (79.3%, 88.7%, and 94.4%, respectively) and overall survival (96.9%, 98.2% and 98.9%, respectively).
• Similarly, the youngest patients at 10 years of age had the lowest rates of late distant metastasis-free survival (89.3%) compared with patients aged 36 to 40 years (94.2%) and 41 to 45 years of age (97.2%).
• Compared with the youngest group, patients aged 36–40 years had a 47% lower risk of late distant recurrence (adjusted hazard ratio (aHR), 0.53; P. = 0.001) and 70% lower in those aged 41-45 (aHR, 0.30; P. P.
• Overall, the findings suggest that younger age is a “significant independent factor” associated with regional recurrence-free survival, disease-free survival, and late distant metastasis-free survival, but not with overall survival.

IN APPLICATION:

The study findings suggest that “younger patients, particularly those aged 35 and younger, exhibit worse oncological outcomes compared with older groups” and that “younger age is an independent factor associated with late (distant recurrence),” the authors wrote. The results provided insights into improving the management of young patients with breast cancer, as well as information on the “need for age-specific treatment approaches,” such as the addition of long-term endocrine therapy or suppression of ovarian function in young patients with high-risk disease.

SOURCE:

The study, conducted by Dong Seung Shin, MD, Seoul Sungkyunkwan Medical University Samsung Medical Center, published online inside JAMA Network Open.

LIMITATIONS:

Conducting this retrospective analysis in a single country and focusing on a single race may limit the generalizability of the findings. The lack of detailed data on the duration of suppression of ovarian function and the limited number of patients receiving ovarian suppression therapy may affect the findings. Additionally, the youngest group had a higher proportion of patients receiving less than 5 years of endocrine therapy.

REMARKS:

This study was supported by grants from the National Research and Development Program for Cancer Control and the Quality of Life in Cancer Foundation. Additional funding was provided by general clinical research grant assistance from the Seoul Metropolitan Government Seoul National University Boramae Medical Center. Some authors report receiving grants or personal fees or have other affiliations with various sources.

This article was created using a variety of editorial tools, including artificial intelligence, as part of the process. Human editors reviewed this content before it was published.