AGE AS A PROGNOSTIC FACTOR IN BREAST-CANCER - RELATIONSHIP TO PATHOLOGICAL AND BIOLOGIC FEATURES

The relationship of age with prognostic factors and outcome of breast cancer has long been controversial due to numerous confounding factors . In order to clarify the prognostic value of age, we analyzed a homog eneous population of 1,266 patients treated for breast cancer at the s ame institution (mean followup: 62 months). Three groups were compared : patients under 35 years of age, non-menopausal patients over 35 year s of age, and post-menopausal patients under the age of 70 years. A hi gher frequency of undifferentiated tumors, histoprognostic grade-3 can cer, microscopic lymph-node involvement and negative hormonal receptor status was observed in patients under 35 years. In addition, clinical but not anatomical tumor size was greater in young patients, suggesti ng higher stromal activity. Metastasis-free survival and overall survi val were significantly poorer before 35 years. Differences were observ ed when patients were matched with regard to stage, anatomic size, his toprognostic grade, microscopic lymph-node involvement and receptor st atus. Multivariate analysis of both overall and metastasis-free surviv al demonstrated that age younger than 35 years was an independent risk factor. Younger women had a higher risk of local recurrence but, unli ke older women, they did not experience any worsening of the already u nfavorable outcome due to recurrence. (C) 1995 Wiley-Liss, Inc.