Trends in breast cancer mortality by stage at diagnosis among young women in the <scp>U</scp>nited <scp>S</scp>tates

Guo, Fangjian; Kuo, Yong Fang; Shih, Ya Chen Tina; Giordano, Sharon H.; Berenson, Abbey B.

doi:10.1002/cncr.31638

Cited by 139 publications

(112 citation statements)

References 46 publications

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“…Pathologic complete response to neoadjuvant systemic therapy in high-risk cancers such as triple negative and Her-2 driven cancers appear to be independent of stage I-III, and thus it is likely that the biological behavior of these tumors is dictated by chemosensitivity more than by their stage. Thus, Guo et al [21] in an excellent SEER-based study of breast cancer in young women concluded that screening has contributed little to the improvements in OS in this population. They concluded that even in the screened population of women > 40 "nearly all of the mortality reduction was caused by treatment advances and NOT screening".…”

Section: Discussionmentioning

confidence: 99%

Breast Cancer Incidence and Behavior in Younger Patients: A Study From the Surveillance, Epidemiology and End Results Database

Nasim¹,

Girtain²,

Gupta³

et al. 2020

World J Oncol

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Background: Breast cancer screening for women less than 40 years old is practically non-existent. Since screening can detect cancer at an early stage, not having a surveillance guideline for breast cancer in younger women can result in detection of the cancer at advanced stages. The purpose of this study was to investigate the incidence and behavior of breast cancer in younger women. Methods: The Surveillance, Epidemiology and End Results (SEER) registry data from 2004 to 2014 were accessed for the study. All women diagnosed with breast cancer and with complete information were included in the study. The data were further divided into two groups based on the age of the patient at the time of diagnosis. The younger group consisted of women < 40 years old (group 1) and the older group consisted of women ≥ 40 years old (group 2). Both groups were compared on demography and characteristics of the cancer. The continuous variables were tested using Student's t-tests and categorical variables were compared using Chi-squared or Fisher's exact tests. Multivariate analysis was done to find the association of high-grade cancer using a logistic regression model. All P-values are two-sided and values < 0.05 were considered statistically significant. Results: Of 599,782 patients who satisfied the inclusion criteria, 28,243 (4.71%) diagnosed with breast cancer were younger women aged < 40 years old. A higher proportion of these younger women presented with larger tumor sizes (between 5.1 and 10.0 cm) (11.61% vs. 5.70%, P < 0.001), poorly differentiated cancer cells (55.88% vs. 32.85%, P < 0.001) and triple negative receptors (6.83% vs. 3.81%, P < 0.001) than older women respectively. Younger age was significantly associated with high-grade tumor at presentation when controlling for race and marital status. There was roughly 3% increased risk of a high-grade tumor with each decrease of 1 year (odds ratio 0.97, 95% confidence interval 0.96-0.99, P = 0.001). Conclusion: This study found that the proportion of breast cancer cases in younger women was just below 5%; however, when the cancer was diagnosed, these women presented in advanced stages and more aggressive cancer types.

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Section: Discussionmentioning

confidence: 99%

Breast Cancer Incidence and Behavior in Younger Patients: A Study From the Surveillance, Epidemiology and End Results Database

Nasim¹,

Girtain²,

Gupta³

et al. 2020

World J Oncol

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“…Jacqueline et al 38 reported that the 5-year breast cancer net survival in females diagnosed between 2001 and 2009 was 88.2% independent of race and age, and the survival rates improved from the 2001 and 2003 to 2004 and 2009. Another study suggested that the 5-year breast cancer-speci c survival increased from 74.0% during 1975-1979 to 88.5% during 2010-2015 in women diagnosed between ages 20 and 39 years from the SEER database 20 . The data obtained in our research were slightly higher than previous studies, which might be due to the recent study year accompanied by the improved treatment methods.…”

Section: Discussionmentioning

confidence: 99%

“…Despite higher rates of LRR in young patients, several studies had shown a declining trend in the LRR rate over the past two decades [14][15][16] . In addition, there has been a signi cant decline in the occurrence of distant metastases (DM) 17,18 and increase in the overall survival over the last years in young breast cancer (YBC) patients owing to the evolution of improved adjuvant systemic treatment and raising consciousness of physical examination 19,20 .…”

Section: Introductionmentioning

confidence: 99%

Loco-Regional Recurrence Trend and Prognosis in Young Women With Breast Cancer According to Molecular Subtypes

Li¹,

Lu²,

Zhang

et al. 2020

Preprint

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Purpose The number of young patients diagnosed with breast cancer is on the rise. We studied the rate trend of local recurrence (LR) and regional recurrence (RR) in young breast cancer (YBC) patients and outcomes among these patients based on molecular subtypes. Methods A retrospective cohort study was conducted based on data from Tianjin Medical University Cancer Institute and Hospital for patients ≤35 years of age with pathologically-confirmed primary invasive breast cancer surgically treated between 2006 and 2014. Patients were categorized according to molecular subtypes on the basis of hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status. The 5-year rates for LR, RR, and distant metastases were estimated by Kaplan-Meir statistics. Nelson-Aalen cumulative-hazard plots were used to describe local recurrence- and distant metastases-free intervals. Results We identified 25,284 patients with a median follow-up of 82 months, of whom 1099 (4.3%) were YBC patients ≤35 years of age. The overall 5-year local, regional, and distant recurrence rates in YBC patients were 6.7%, 5.1%, and 16.6%, respectively. The LR and RR rates demonstrated a decreasing trend over time (P=0.028 and P=0.015, respectively). We found that early-stage breast cancer and less lymph node metastases increased over time (P=0.004 and P=0.007, respectively). Patients with HR-/HER2+ status had a significantly higher LR (HR 20.4; 95% CI,11.8-35.4) and DM (HR 37.2; 95% CI, 24.6-56.3) at 10 years. In the overall population, the 5-year survival of YBC patients exceeded 90%. Conclusion The rates of LR and RR with YBC patients demonstrated a downward trend and the proportion of early-stage breast cancer increased between 2006 and 2014. We report that the outcomes varied with molecular subtypes and patients with HR-/HER2+ status had the worst survival.

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“…Breast cancer is among the most common malignancies and a leading cause of death in women [1]. However, advances in surgical techniques and systemic therapies have improved the survival of breast cancer patients in recent decades [2]. Breast cancer is a heterogeneous disease with a variety of pathologic and molecular features.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Significance of SMAD4 Expression in Breast Cancer

2019

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Purpose: SMAD4 is a member of the SMAD family and acts as a central mediator of transforming growth factor beta signaling. Little is known about SMAD4 expression and its prognostic significance in breast cancer. We evaluated the clinicopathological and prognostic significance of SMAD4 expression in breast cancer. Methods: Two hundred and fifty-five patients with invasive ductal carcinoma of the breast from 2000 to 2008 were retrospectively analyzed. We investigated SMAD4 expression using a tissue microarray-based immunohistochemical assay and evaluated the association between SMAD4 and prognosis of breast cancer. Results: High SMAD4 expression was positively associated with early stage (p= 0.009), estrogen receptor positivity (p= 0.026), and human epidermal growth factor receptor 2 negativity (p= 0.001). A significant difference in overall survival (OS) was associated with high SMAD4 expression in patients with T1 stage tumors (hazard ratio: 0.459, p= 0.024). Conclusion: High SMAD4 expression was correlated with several favorable prognostic factors and was associated with favorable OS in T1 stage breast cancer. SMAD4 in breast cancer has potential prognostic significance, and further investigations and understanding about SMAD4 expression are needed.

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Trends in breast cancer mortality by stage at diagnosis among young women in the United States

Cited by 139 publications

References 46 publications

Breast Cancer Incidence and Behavior in Younger Patients: A Study From the Surveillance, Epidemiology and End Results Database

Breast Cancer Incidence and Behavior in Younger Patients: A Study From the Surveillance, Epidemiology and End Results Database

Loco-Regional Recurrence Trend and Prognosis in Young Women With Breast Cancer According to Molecular Subtypes

Clinicopathological Significance of SMAD4 Expression in Breast Cancer

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