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Different prognosis of young breast cancer patients in their 20s and 30s depending on subtype: a nationwide study from the Korean Breast Cancer Society

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Abstract

Purpose

Numerous studies have demonstrated that breast cancer in young women (BCY) has unfavorable prognostic features and more unfavorable subtypes. However, few studies have evaluated the effect of subtype disparities on breast cancer prognosis by age, especially for BCY. We analyzed breast cancer mortality stratified by tumor subtype according to age among patients younger than 50 years.

Methods

Data from the Korean Breast Cancer Society Registry for patients diagnosed with invasive breast cancer when aged less than 50 years between 2003 and 2010 were reviewed retrospectively.

Results

We identified 30,793 patients with breast cancer who were eligible for analysis. Of these, 793 (2.6%) were aged 20–29 and 8926 (28.8%) were aged 30–39. Median follow-up duration was 84 months. Mean age was 42.4 years. Patients in their 20s were more likely to have cancer of advanced stage and higher nuclear grade, present with lymphovascular invasion, and have unfavorable subtypes. Patients in the 20s group showed worse prognosis. In multivariate analysis for overall survival (OS), the hazard ratio (HR) for patients in the 20s group was higher than that for the 30s and 40s groups, and patients with triple-negative breast cancer (TNBC) showed higher HR than patients with HER-2 or luminal subtype (all p < 0.0001). When stratified by subtype, luminal subtype showed significantly worse prognosis in the 20s group than the 30s and 40s groups, whereas HER-2 and TNBC subtypes showed no significant difference.

Conclusion

Patients in their 20s with breast cancer had unfavorable characteristics and worse prognosis than patients in their 30s and 40s. When stratified by tumor subtype, patients in their 20s with luminal subtype of breast cancer showed worse prognosis than older patients, whereas HER-2 and TNBC subtypes showed no significant differences.

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Acknowledgements

This article was supported by the Korean Breast Cancer Society, by the Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (2015R1D1A1A01057585) and by the National Research Foundation of Korea (NRF) Grant funded by the Korean Government (MSIP) (2016R1A5A2945889), and by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI17C1142).

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Author notes

  1. Jai Min Ryu and Jonghan Yu have contributed equally to this work.

Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 5th floor Breast-endocrine, Irwon-ro 81, Gangnam-gu, Seoul, 06351, South Korea

    Jai Min Ryu, Jonghan Yu, Seok Jin Nam, Jeong Eon Lee, Se Kyung Lee & Seok Won Kim

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Seung Il Kim

  3. Breast-Thyroid Center, Ulsan City Hospital Group, Ulsan City Hospital, Ulsan, South Korea

    Ku Sang Kim

  4. Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Hyeong-Gon Moon

  5. Department of Surgery, Yeungnam University Medical Center, Daegu, South Korea

    Jung Eun Choi

  6. Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Joon Jeong

  7. Breast Center, Dong-A University Hospital, Busan, South Korea

    Kyung Do Byun

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  1. Jai Min Ryu
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  2. Jonghan Yu
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  11. Se Kyung Lee
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  12. Seok Won Kim
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Correspondence to Seok Won Kim.

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Ryu, J.M., Yu, J., Kim, S.I. et al. Different prognosis of young breast cancer patients in their 20s and 30s depending on subtype: a nationwide study from the Korean Breast Cancer Society. Breast Cancer Res Treat 166, 833–842 (2017). https://doi.org/10.1007/s10549-017-4472-5

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  • DOI: https://doi.org/10.1007/s10549-017-4472-5

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