Objective: To make a prognostic effect analysis of molecular subtype on young breast cancer patients.Methods: Totally 187 cases of young breast cancer patients less than 40 years old treated in Obstetrics and Gyneco...Objective: To make a prognostic effect analysis of molecular subtype on young breast cancer patients.Methods: Totally 187 cases of young breast cancer patients less than 40 years old treated in Obstetrics and Gynecology Hospital of Fudan University between June 2005 and June 2011 were included in our study. We described their clinical-pathological characteristics, disease-free survival(DFS) rate, and overall survival(OS) rate after a median follow-up period of 61 months. The factors associated with prognosis were also evaluated by univariate and multivariate analyses.Results: All patients were premenopausal, with an average age of 35.36±3.88 years old. The mean tumor size was 2.43±1.53 cm. Eighty-one cases had lymph node metastasis(43.3%), 126 cases had lymphovascular invasion(67.4%), and 125 cases had histological grade III(66.8%) disease. Twenty-seven cases(14.4%) were Luminal A subtype, 99 cases(52.9%) were Luminal B subtype, 29 cases(15.5%) were human epidermal growth factor receptor 2(HER-2) overexpression subtype, while 32 cases(17.1%) were triple negative breast cancer(TNBC) subtype according to 2013 St Gallen expert consensus. One hundred and thirty-five cases underwent mastectomy whereas 52 cases had breast-conserving surgery. One hundred and seventy-eight cases underwent adjuvant or neoadjuvant chemotherapy. Recurrence or metastasis occurred in 29 cases, 13 of which died. The 5-year DFS and OS rates were 84% and 92%. Multivariate analysis showed that nodal status(P=0.041) and molecular subtype(P=0.037) were both independent prognostic factors of DFS, while nodal status(P=0.037) and TNBC subtype(P=0.048) were both independent prognostic factors of OS. Conclusions: Molecular subtype is an independent prognostic factor of young breast cancer patients. TNBC has a high risk of relapse and death.展开更多
Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics...Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics,management and outcomes of young breast cancer patients over time.Methods: Females under 40 years of age diagnosed with breast cancer during the periods 1999-2017 and1999-2015 were identified in the Fudan University Shanghai Cancer Center(FUSCC) and the population-based Surveillance, Epidemiology, and End Results(SEER) registry, respectively. Clinicopathologic characteristics and treatment information were collected. Patients diagnosed before 2013 were followed up.Results: The proportions of young breast cancer patients were 15.0% and 5.3% in the FUSCC and SEER cohorts, respectively. In the FUSCC cohort, there was a significant increase in the proportion of ductal carcinoma in situ(DCIS)(from 8.8% to 16.9%;P<0.0001) and it remained stable in SEER cohort. The proportion of T1-stage tumors increased dramatically in the FUSCC cohort(from 35.3% to 41.9%;P=0.008), whereas it decreased in SEER cohort(from 42.4% to 33.0%;P<0.0001). The percentage of estrogen receptor(ER)-positive cancers was consistently increased in both the invasive ductal carcinoma(IDC) and DCIS patients in the two cohorts. Breastconserving surgery and immediate implant reconstruction after mastectomy both exhibited increased use over time in the FUSCC cohort. Both the FUSCC and SEER cohorts showed a significantly better prognosis in the recent time period.Conclusions: With the increased early-stage and ER-positive diseases in young patients as well as better systemic treatment strategies, improved survival has been observed in recent years. There has been a substantial deescalation in surgical therapies in young breast cancer patients.展开更多
Introduction: Breast cancer is the most common cancer in women worldwide, with an increasing incidence. Although it is rare and no much studied in young women, it represents 7% of cases worldwide and often appears mor...Introduction: Breast cancer is the most common cancer in women worldwide, with an increasing incidence. Although it is rare and no much studied in young women, it represents 7% of cases worldwide and often appears more aggressive with a poor prognosis compared to its counterpart in older women. The main objective of our study was to describe the histological and phenotypic aspects of breast cancer in women of age under 40. Methodology: We conducted a descriptive and analytical cross-sectional study, with retrospective collection of data over a period of 05 years. All women diagnosed with breast cancer were included and divided into 2 study groups: under 40 years old and over 40 years old. Data were analyzed using SPSS version 23.0 software, compared using the Chi square or Fisher exact test. A p value Results: We retained 196 files, either 89 for those under 40 and 107 for those over 40. Young patients with breast cancer had a higher stage, grade and tumor size. Lymph node involvement was more observed in women under 40 years (69.6% vs 53.2%). Older women were more likely to be hormone receptor positive (54.2% vs 38.2%);p = 0.018. HER-2 overexpression was higher in women younger than 40 years (39.32% vs 25.23%);p = 0.080 with a high Ki67 proliferation index (30.3% versus 2.8%);p 0.001. Triple-negative and Her-2 tumors were much more frequent in young women (48.3% vs. 36.4%;p = 0.063) and (17.97% vs. 10.3%;p = 0.125). Conclusion: Breast cancer in young women remains more aggressive and is dominated by triple negative and Her-2 phenotypes.展开更多
Breast cancer is the most common cancer in women worldwide, constituting 25% of all cancer diagnoses. Even though it is only affecting 4% - 6% of women under the age of 40, it remains the most...Breast cancer is the most common cancer in women worldwide, constituting 25% of all cancer diagnoses. Even though it is only affecting 4% - 6% of women under the age of 40, it remains the most common malignancy among younger patients. Advancement in the treatment and earlier detection gives excellent 5 years of survival. However, the standard treatment that comprises surgical-chemo radiation therapy or hormonal treatment often results in an increased incidence of treatment-induced infertility. Therefore, adding fertility preservation to primary cancer treatment may offer the best opportunity for future fertility. However, despite advancements in Assisted Reproductive Technology (ART), the uptake of fertility services in this group remains low. In this review, we highlighted the effect of all breast cancer treatments on women’s fertility, the effectiveness and safety of ART in breast cancer patients as well as the safety of pregnancy in breast cancer survivors. Our aim is to improve awareness of fertility preservation for breast cancer to ensure all women diagnosed with breast cancer have multidisciplinary approaches with early referral to fertility specialists to discuss regarding potential risks and benefits of fertility preservation to improve the uptake of fertility preservation among this group of patients.展开更多
Objective: To describe the epidemiological, clinical and therapeutic characteristics of women under 40 years followed for breast cancer. Method: This is a retrospective and cohort study with descriptive purpose conduc...Objective: To describe the epidemiological, clinical and therapeutic characteristics of women under 40 years followed for breast cancer. Method: This is a retrospective and cohort study with descriptive purpose conducted over 10 years on the management of breast cancer in 105 patients under 40 years in the Gynecology Service of the University and Hospital Center of Treichville. Results: The incidence of breast cancer in women under 40 years was 8.4%, and the majority of patients were over 35 years old (64.8%) and had a low socioeconomic level (61.7%). Some patients had classic risk factors for breast cancer: menarche before 12 years (48.6%), nulliparity (20%), family history of breast cancer (1.9%). The discovery of a breast abnormality was made by patients in 97.1% of the cases. Cancers were either isolated (92.4%) or associated with pregnancy (5.7%) or bilateral (1.9%). The majority of cancers were infiltrating ductal carcinomas (86.7%), of SBR II grade (69%). Patients generally benefited from a mastectomy with axillary dissection, framed by chemotherapy. The global survival at 10 years was 5%. Conclusion: This study allowed us to confirm that breast cancers in younger women were a reality in our country and posed us enormous difficulties in their management.展开更多
Purpose: This study aimed to evaluate whether young adult breast cancer patients have poor outcomes independent of established prognostic factors and analyze differences in prognosis between younger and older patients...Purpose: This study aimed to evaluate whether young adult breast cancer patients have poor outcomes independent of established prognostic factors and analyze differences in prognosis between younger and older patients stratified by tumor subtype. Methods: Of 10,950 breast cancer patients treated at West China Hospital between 1998 and 2017, 741 younger patients (Results: We identified 11 parameters (all P P P P = 0.024] and HR for DFS = 1.301 [95% CI, 1.077 - 1.572;P = 0.006]). When stratified by tumor subtype, younger patients with T1, N0, tumor stage I, G3, estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and Ki67 ≥ 14% had a poor BCSS;in addition, patients with T1, N1, tumor stages I and II, G3, ER-negative, PR-negative, and triple-negative had a poorer DFS than older patients. Conclusion: Young age was an independent prognostic factor for BCSS and DFS in breast cancer patients. The increased risk of relapse was most pronounced in early-stage breast cancer, especially in patients with ER-negative disease.展开更多
Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the differe...Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: Luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.展开更多
文摘Objective: To make a prognostic effect analysis of molecular subtype on young breast cancer patients.Methods: Totally 187 cases of young breast cancer patients less than 40 years old treated in Obstetrics and Gynecology Hospital of Fudan University between June 2005 and June 2011 were included in our study. We described their clinical-pathological characteristics, disease-free survival(DFS) rate, and overall survival(OS) rate after a median follow-up period of 61 months. The factors associated with prognosis were also evaluated by univariate and multivariate analyses.Results: All patients were premenopausal, with an average age of 35.36±3.88 years old. The mean tumor size was 2.43±1.53 cm. Eighty-one cases had lymph node metastasis(43.3%), 126 cases had lymphovascular invasion(67.4%), and 125 cases had histological grade III(66.8%) disease. Twenty-seven cases(14.4%) were Luminal A subtype, 99 cases(52.9%) were Luminal B subtype, 29 cases(15.5%) were human epidermal growth factor receptor 2(HER-2) overexpression subtype, while 32 cases(17.1%) were triple negative breast cancer(TNBC) subtype according to 2013 St Gallen expert consensus. One hundred and thirty-five cases underwent mastectomy whereas 52 cases had breast-conserving surgery. One hundred and seventy-eight cases underwent adjuvant or neoadjuvant chemotherapy. Recurrence or metastasis occurred in 29 cases, 13 of which died. The 5-year DFS and OS rates were 84% and 92%. Multivariate analysis showed that nodal status(P=0.041) and molecular subtype(P=0.037) were both independent prognostic factors of DFS, while nodal status(P=0.037) and TNBC subtype(P=0.048) were both independent prognostic factors of OS. Conclusions: Molecular subtype is an independent prognostic factor of young breast cancer patients. TNBC has a high risk of relapse and death.
基金supported in part by grants from the Shenkang center city hospital emerging frontier technology joint research project (No. SHDC12015119)National Key R&D Program of China (No. 2017YFC1311004)
文摘Objective: Breast cancer in young females was usually considered more aggressive and requires aggressive therapy. We investigated whether early detection and improved treatments changed the patterns of characteristics,management and outcomes of young breast cancer patients over time.Methods: Females under 40 years of age diagnosed with breast cancer during the periods 1999-2017 and1999-2015 were identified in the Fudan University Shanghai Cancer Center(FUSCC) and the population-based Surveillance, Epidemiology, and End Results(SEER) registry, respectively. Clinicopathologic characteristics and treatment information were collected. Patients diagnosed before 2013 were followed up.Results: The proportions of young breast cancer patients were 15.0% and 5.3% in the FUSCC and SEER cohorts, respectively. In the FUSCC cohort, there was a significant increase in the proportion of ductal carcinoma in situ(DCIS)(from 8.8% to 16.9%;P<0.0001) and it remained stable in SEER cohort. The proportion of T1-stage tumors increased dramatically in the FUSCC cohort(from 35.3% to 41.9%;P=0.008), whereas it decreased in SEER cohort(from 42.4% to 33.0%;P<0.0001). The percentage of estrogen receptor(ER)-positive cancers was consistently increased in both the invasive ductal carcinoma(IDC) and DCIS patients in the two cohorts. Breastconserving surgery and immediate implant reconstruction after mastectomy both exhibited increased use over time in the FUSCC cohort. Both the FUSCC and SEER cohorts showed a significantly better prognosis in the recent time period.Conclusions: With the increased early-stage and ER-positive diseases in young patients as well as better systemic treatment strategies, improved survival has been observed in recent years. There has been a substantial deescalation in surgical therapies in young breast cancer patients.
文摘Introduction: Breast cancer is the most common cancer in women worldwide, with an increasing incidence. Although it is rare and no much studied in young women, it represents 7% of cases worldwide and often appears more aggressive with a poor prognosis compared to its counterpart in older women. The main objective of our study was to describe the histological and phenotypic aspects of breast cancer in women of age under 40. Methodology: We conducted a descriptive and analytical cross-sectional study, with retrospective collection of data over a period of 05 years. All women diagnosed with breast cancer were included and divided into 2 study groups: under 40 years old and over 40 years old. Data were analyzed using SPSS version 23.0 software, compared using the Chi square or Fisher exact test. A p value Results: We retained 196 files, either 89 for those under 40 and 107 for those over 40. Young patients with breast cancer had a higher stage, grade and tumor size. Lymph node involvement was more observed in women under 40 years (69.6% vs 53.2%). Older women were more likely to be hormone receptor positive (54.2% vs 38.2%);p = 0.018. HER-2 overexpression was higher in women younger than 40 years (39.32% vs 25.23%);p = 0.080 with a high Ki67 proliferation index (30.3% versus 2.8%);p 0.001. Triple-negative and Her-2 tumors were much more frequent in young women (48.3% vs. 36.4%;p = 0.063) and (17.97% vs. 10.3%;p = 0.125). Conclusion: Breast cancer in young women remains more aggressive and is dominated by triple negative and Her-2 phenotypes.
文摘Breast cancer is the most common cancer in women worldwide, constituting 25% of all cancer diagnoses. Even though it is only affecting 4% - 6% of women under the age of 40, it remains the most common malignancy among younger patients. Advancement in the treatment and earlier detection gives excellent 5 years of survival. However, the standard treatment that comprises surgical-chemo radiation therapy or hormonal treatment often results in an increased incidence of treatment-induced infertility. Therefore, adding fertility preservation to primary cancer treatment may offer the best opportunity for future fertility. However, despite advancements in Assisted Reproductive Technology (ART), the uptake of fertility services in this group remains low. In this review, we highlighted the effect of all breast cancer treatments on women’s fertility, the effectiveness and safety of ART in breast cancer patients as well as the safety of pregnancy in breast cancer survivors. Our aim is to improve awareness of fertility preservation for breast cancer to ensure all women diagnosed with breast cancer have multidisciplinary approaches with early referral to fertility specialists to discuss regarding potential risks and benefits of fertility preservation to improve the uptake of fertility preservation among this group of patients.
文摘Objective: To describe the epidemiological, clinical and therapeutic characteristics of women under 40 years followed for breast cancer. Method: This is a retrospective and cohort study with descriptive purpose conducted over 10 years on the management of breast cancer in 105 patients under 40 years in the Gynecology Service of the University and Hospital Center of Treichville. Results: The incidence of breast cancer in women under 40 years was 8.4%, and the majority of patients were over 35 years old (64.8%) and had a low socioeconomic level (61.7%). Some patients had classic risk factors for breast cancer: menarche before 12 years (48.6%), nulliparity (20%), family history of breast cancer (1.9%). The discovery of a breast abnormality was made by patients in 97.1% of the cases. Cancers were either isolated (92.4%) or associated with pregnancy (5.7%) or bilateral (1.9%). The majority of cancers were infiltrating ductal carcinomas (86.7%), of SBR II grade (69%). Patients generally benefited from a mastectomy with axillary dissection, framed by chemotherapy. The global survival at 10 years was 5%. Conclusion: This study allowed us to confirm that breast cancers in younger women were a reality in our country and posed us enormous difficulties in their management.
文摘Purpose: This study aimed to evaluate whether young adult breast cancer patients have poor outcomes independent of established prognostic factors and analyze differences in prognosis between younger and older patients stratified by tumor subtype. Methods: Of 10,950 breast cancer patients treated at West China Hospital between 1998 and 2017, 741 younger patients (Results: We identified 11 parameters (all P P P P = 0.024] and HR for DFS = 1.301 [95% CI, 1.077 - 1.572;P = 0.006]). When stratified by tumor subtype, younger patients with T1, N0, tumor stage I, G3, estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and Ki67 ≥ 14% had a poor BCSS;in addition, patients with T1, N1, tumor stages I and II, G3, ER-negative, PR-negative, and triple-negative had a poorer DFS than older patients. Conclusion: Young age was an independent prognostic factor for BCSS and DFS in breast cancer patients. The increased risk of relapse was most pronounced in early-stage breast cancer, especially in patients with ER-negative disease.
文摘Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: Luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.