Age Under 30 Years As a Predictor of Poor Survival in a Cohort of Mexican Women With Breast Cancer

Abstract

Introduction Young women under 30 years with breast cancer (BC) are an emerging challenge. The purpose is to identify prognostic factors for survival in young women under 30 years of age with BC. Material and methods A retrospective cohort study was conducted among women younger than or equal to 40 years with BC and who were treated at the State Cancer Center during the period 2012–2017. Overall survival was assessed using the Kaplan–Meier method and the log-rank test. Univariate and multivariate analysis assessed survival predictors using Cox proportional hazards regression model. Results 282 young women were included. The >30-year-old subgroup showed a significant association with excess weight ( P = .002) compared to the <30-year-old group. The <30-year-old subgroup showed a poor overall survival (56.7%), as well as highly significant values in advanced clinical stages, metastatic nodules, metastasis, and neoadjuvant therapy ( P < .001). In Model 3 of the multivariate analysis, age <30 years (HR = 3.0; 95% CI 1.1 to 8.6), triple negative subtype (HR = 2.6; 95% CI 1.1 to 6.0), tumor size >5 cm HR = 2.3; 95% CI 1.03 to 5.1), and advanced clinical stages (HR = 6.6 95% CI 1.3 to 35.5) persisted as predictors. Conclusions Being very young (<30 years) is a predictor for limited survival compared to the age of 30–40 years, as well as the tumor covariates for a worse prognosis: triple negative subtype, advanced stages, positive lymph nodes, and distant metastases in liver.

What Is Known about Breast Cancer in Young Women?

“…Women aged <40 years were 44% (HR = 1.44; 95% CI: 1.27–1.64) and 9% (HR = 1.09; 95% CI: 1.03–1.15) more likely to die of stage I and stage II breast cancer, respectively [ 204 ]. Further, a significantly lower overall survival (OS) and disease-free survival (DFS) have been reported in Mexican, Hungarian, and Indian cohorts in very young (<35 years of age) women compared to young (<45 years), which may be related to the more aggressive subtypes of tumours developing in earlier ages [ 205 , 206 , 207 ]. Bajpai et al conducted a prospective cohort study enrolling 1228 women aged ≤40 years.…”

Delineation of Pathogenomic Insights of Breast Cancer in Young Women

“…Studies have shown that BCYW is generally more aggressive with a poorer prognosis than BC in older patients [ 16 , 17 , 18 ]. A high prevalence of TNBC, basal-like tumors, and luminal B exists in BCYW [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. However, the effect of cancer subtypes on the genome of women with BC aged ≤40 years remains poorly studied.…”

“…The range of clinical characteristics exhibited in BCYW is distinct from that exhibited in older premenopausal and postmenopausal women with BC; thus, BCYW could be considered a subset of premenopausal diseases. BCYW exhibits more aggressive cancer subtypes (such as TNBC/basal, HER2-positive, and luminal B) than BC in older patients [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. The prognosis of BCYW is generally worse than that of BC in older patients, presumably due to its aggressive subtypes, detection at an advanced stage, and a high recurrence rate [ 1 , 6 , 15 , 16 , 17 , 18 , 19 ].…”

Diagnostic delays in breast cancer among young women: An emphasis on healthcare providers

“…The distribution of these molecular subtypes varies across age groups, with luminal B, HER2-positive, and basal-like tumors being more prevalent in younger women compared to older breast cancer patients [ 1 , 2 , 18 ]. In the BCYW age group, a significant percentage (about 34%–37 %) of women have triple-negative breast cancers in different studies [ [19] , [20] , [21] ], which may look like homogeneous hypoechoic lesions with smooth rounded borders; these can often be misreported as fibroadenomas and ignored. 3) some patients are young mothers who may be mislabeled as having galactoceles.…”