Prognostic significance of young age in breast cancer

Background: Breast carcinoma is relatively uncommon in younger women and wh ether or not young age at diagnosis is an adverse prognostic factor in this disease has been controversial. Our aim in this report is to determine whe ther the histopathologic features and outcome in young and old are differen t, and whether age is a prognostic factor for relapse. Methods: A retrospective study of consecutive 281 stage I or II breast carc inoma patients who had modified radical mastectomy was carried out. The pat ients with a median follow-up period of 45 months were divided two groups a ccording to their ages. The histopathological features and survival of Grou p 1 and Group 2 were compared with each other. Univariate and multivariate prognostic factor analysis for relapse were carried out. Results: The patients in Group 1 (younger than 35 years of age) had the wor st histopathological features related to the prognosis than those in Group 2 and the difference between the two groups was statistically significant. Whereas the rates of 5-year overall survival were 65% in Group 1 and 98% in Group 2 (P < 0.05), the rates of 5-year relapse-free survival were 40% and 80%, respectively (P < 0.05). In univariate analysis of all patients, path ologic tumour size, pathologic axillary status, number of metastatic lymph nodes, pathologic stage, age, lymphatic vascular invasion were statisticall y significant factors associated with relapse. Multivariate analysis demons trated that number of metastatic nodes (risk ratio RR:4.3 in more than thre e nodes) and age (RR:3.6 in Group 1) were the most important independent pr ognostic factors for relapse. In the patients without axillary involvement, both of univariate and multivariate analysis revealed that pathologic tumo ur size (RR:5.1 in pT(2)) and age (RR:4 in Group 1) were the independent pr ognosticators for relapse. Conclusions: Young patients with breast cancer had the worst histopathologi cal features and the worst survival than their older counterparts. Age was an independent significant prognostic factor for relapse. (C) 2000 Wiley-Li ss, Inc.