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Luminal B subtype: a key factor for the worse prognosis of young breast cancer patients in China.

Tang LC, Jin X, Yang HY, He M, Chang H, Shao ZM, Di GH - BMC Cancer (2015)

Bottom Line: More grade III tumors and more lymph-vascular invasions (P < 0.01) were presented in <40y group when compared with 40-50y group.Younger patients with tumors of both Luminal A and Luminal B types were at increased risk for worse DFS (P = 0.03, HR = 1.69, 95% CI = 1.05-2.72; P < 0.01, HR = 3.61, 95% CI = 2.50-5.22) when compared with the older patients.Luminal B subtype may have a negative effect on the prognosis of young patients in China which should be validated further.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. forever_drawer@163.com.

ABSTRACT

Background: The prognoses of young breast cancer patients are poor. The purpose of this study is to evaluate the different characteristics and prognoses among different subtypes of young breast cancer patients.

Methods: The study included 1360 patients <40 years-old (y) and 3110 patients 40-50y with operable breast cancer in Shanghai Cancer Center, Fudan University. The characteristics, overall survival (OS) and disease-free survival (DFS) were compared.

Results: The median follow-up was 54.1 months. More grade III tumors and more lymph-vascular invasions (P < 0.01) were presented in <40y group when compared with 40-50y group. More patients <40y presented with Luminal B (25.3% vs. 17.5%, P < 0.01) and triple negative (16.7% vs. 13.4%, P < 0.05) breast cancer while fewer had Luminal A tumor (48.5% vs. 59.2%, P < 0.01). Younger patients with tumors of both Luminal A and Luminal B types were at increased risk for worse DFS (P = 0.03, HR = 1.69, 95% CI = 1.05-2.72; P < 0.01, HR = 3.61, 95% CI = 2.50-5.22) when compared with the older patients. Patients <40y with Luminal B tumor had a two point five fold higher risk of death compared with older counterparts (P < 0.01, HR = 2.54, 95% CI = 1.35-4.79), however, a worse overall survival rate was not observed in the younger women with Luminal A breast cancer (P > 0.05). In multivariate analysis, Luminal B subtype was also a strong predictor of disease relapse (HR = 1.09, 95% CI = 1.01 to 1.19, P < 0.01) in younger patients with Luminal subtype tumors.

Conclusion: Characteristics of breast cancer suggested a more aggressive biology in Chinese patients with breast cancer diagnosed at young age. Luminal B subtype may have a negative effect on the prognosis of young patients in China which should be validated further.

No MeSH data available.


Related in: MedlinePlus

CONSORT diagram of inclusion criteria and exclusion criteria for study.
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Fig1: CONSORT diagram of inclusion criteria and exclusion criteria for study.

Mentions: The medical records of 2138 and 4747 female patients aged <40y and 40-50y who had breast cancer diagnosed first time and were treated with breast surgery between Jan 1st, 2003 and December 31st, 2012, were retrospectively reviewed. This study was approved by the Ethics Committee of Shanghai Cancer Hospital, Fudan University. The information was retrieved from the database of the Shanghai Cancer Center, Fudan University, Shanghai, China. All patients were staged according to the 2007 American Joint Committee on Cancer (AJCC) guidelines [8,9]. Seven hundred and seventy-eight and 1637 patients were excluded from the two groups respectively according to the inclusion and exclusion criteria listed in Figure 1. Patients who required neoadjuvant therapy or who had metastastic disease were not included. Clinical and pathologic characteristics of these patients were classified by the inpatients’ computerised database, as required by the REMARK criteria [10,11]. All patients were required to have a complete physical examination, bilateral mammography, chest radioscopy, ECG, ultrasonography of breasts, axillary fossa, cervical parts, abdomen and pelvis, and routine blood and biochemical tests before surgery and adjuvant therapy when appropriate. Outpatient department records and records of personal contact with the patients, including routine correspondence and/or telephone calls, were used to follow the patients and determine the occurrence of loco-regional recurrence, distant metastasis or death. Patients returned to the Shanghai Cancer Center, Fudan University for follow-up every 3 months during the first 2 years, every 6 months in the third to fifth years, and annually after 5 years.Figure 1


Luminal B subtype: a key factor for the worse prognosis of young breast cancer patients in China.

Tang LC, Jin X, Yang HY, He M, Chang H, Shao ZM, Di GH - BMC Cancer (2015)

CONSORT diagram of inclusion criteria and exclusion criteria for study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389816&req=5

Fig1: CONSORT diagram of inclusion criteria and exclusion criteria for study.
Mentions: The medical records of 2138 and 4747 female patients aged <40y and 40-50y who had breast cancer diagnosed first time and were treated with breast surgery between Jan 1st, 2003 and December 31st, 2012, were retrospectively reviewed. This study was approved by the Ethics Committee of Shanghai Cancer Hospital, Fudan University. The information was retrieved from the database of the Shanghai Cancer Center, Fudan University, Shanghai, China. All patients were staged according to the 2007 American Joint Committee on Cancer (AJCC) guidelines [8,9]. Seven hundred and seventy-eight and 1637 patients were excluded from the two groups respectively according to the inclusion and exclusion criteria listed in Figure 1. Patients who required neoadjuvant therapy or who had metastastic disease were not included. Clinical and pathologic characteristics of these patients were classified by the inpatients’ computerised database, as required by the REMARK criteria [10,11]. All patients were required to have a complete physical examination, bilateral mammography, chest radioscopy, ECG, ultrasonography of breasts, axillary fossa, cervical parts, abdomen and pelvis, and routine blood and biochemical tests before surgery and adjuvant therapy when appropriate. Outpatient department records and records of personal contact with the patients, including routine correspondence and/or telephone calls, were used to follow the patients and determine the occurrence of loco-regional recurrence, distant metastasis or death. Patients returned to the Shanghai Cancer Center, Fudan University for follow-up every 3 months during the first 2 years, every 6 months in the third to fifth years, and annually after 5 years.Figure 1

Bottom Line: More grade III tumors and more lymph-vascular invasions (P < 0.01) were presented in <40y group when compared with 40-50y group.Younger patients with tumors of both Luminal A and Luminal B types were at increased risk for worse DFS (P = 0.03, HR = 1.69, 95% CI = 1.05-2.72; P < 0.01, HR = 3.61, 95% CI = 2.50-5.22) when compared with the older patients.Luminal B subtype may have a negative effect on the prognosis of young patients in China which should be validated further.

View Article: PubMed Central - PubMed

Affiliation: Department of Breast Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. forever_drawer@163.com.

ABSTRACT

Background: The prognoses of young breast cancer patients are poor. The purpose of this study is to evaluate the different characteristics and prognoses among different subtypes of young breast cancer patients.

Methods: The study included 1360 patients <40 years-old (y) and 3110 patients 40-50y with operable breast cancer in Shanghai Cancer Center, Fudan University. The characteristics, overall survival (OS) and disease-free survival (DFS) were compared.

Results: The median follow-up was 54.1 months. More grade III tumors and more lymph-vascular invasions (P < 0.01) were presented in <40y group when compared with 40-50y group. More patients <40y presented with Luminal B (25.3% vs. 17.5%, P < 0.01) and triple negative (16.7% vs. 13.4%, P < 0.05) breast cancer while fewer had Luminal A tumor (48.5% vs. 59.2%, P < 0.01). Younger patients with tumors of both Luminal A and Luminal B types were at increased risk for worse DFS (P = 0.03, HR = 1.69, 95% CI = 1.05-2.72; P < 0.01, HR = 3.61, 95% CI = 2.50-5.22) when compared with the older patients. Patients <40y with Luminal B tumor had a two point five fold higher risk of death compared with older counterparts (P < 0.01, HR = 2.54, 95% CI = 1.35-4.79), however, a worse overall survival rate was not observed in the younger women with Luminal A breast cancer (P > 0.05). In multivariate analysis, Luminal B subtype was also a strong predictor of disease relapse (HR = 1.09, 95% CI = 1.01 to 1.19, P < 0.01) in younger patients with Luminal subtype tumors.

Conclusion: Characteristics of breast cancer suggested a more aggressive biology in Chinese patients with breast cancer diagnosed at young age. Luminal B subtype may have a negative effect on the prognosis of young patients in China which should be validated further.

No MeSH data available.


Related in: MedlinePlus