Abstract
Background
Although breast cancer (BC) is uncommon in women age ≤ 35 years, women in this age
group may have more aggressive cancer subtypes and high-risk pathogenic variants (HRPVs).
Higher recurrence and mortality rates in young patients may be related to differences
in tumor biology, pathologic mutation status, or treatment. The purpose of this study
was to evaluate germline mutation status and other factors that affect recurrence-free
survival (RFS) and overall survival (OS) in young women with BC.
Materials and Methods
This was a retrospective study of women diagnosed with BC at age ≤ 35 years at Allina
Health System from 2000 through 2017 (n = 306). Information was collected on germline
mutation status, tumor characteristics (grade, hormone receptor, and human epidermal
growth factor receptor 2), molecular subtype, pregnancy-associated cancers, and treatment.
Survival analyses using Kaplan-Meier curves were conducted for RFS and OS.
Results
With mean follow-up of 6.5 years, OS was 87.0% for invasive cancers, RFS was 84.7%;
69% obtained genetic testing, and 26.9% had HRPVs. There were no differences in RFS
or OS between patients with HRPV versus unknown/low/moderate risk variants. Recurrence
analysis showed increased recurrence rates in luminal B-like cancers followed by triple
negative and human epidermal growth factor receptor 2-positive cancers (P = .041). Pregnancy-associated BC diagnoses, angiolymphatic invasion, and tumor stage
were associated with reduced OS. In spite of young age at diagnosis, nearly one-third
of patients did not receive germline genetic testing.
Conclusions
Similar survival patterns were found between women with HRPV versus no known mutations.
Luminal B-like subtype, pregnancy-associated BC, angiolymphatic invasion, and cancer
stage were associated with reduced OS.
Keywords
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Article Info
Publication History
Published online: July 08, 2020
Accepted:
July 6,
2020
Received in revised form:
July 2,
2020
Received:
April 21,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
