Clinicopathologic Features And Analysis Of Prognostic Factors In Premenopausal Breast Cancer Patients

?Subject? Previous studies have shown that young women are at high risk of recurrence and death,however,the roles of the clinicpathological characteristics and treatment are not adequately addressed.We aimed to study the relationships between clinicpathological characteristics and survival in Chinese premenopausal breast cancer patients.?Method? We extracted information of operable premenopausal early breast cancer patients from January 2009 to December 2013 in the database of Comprehensive Breast Health Center in Ruijin Hospital,Shanghai,China.Descriptive statistical methods and survival analysis were adopted in the analysis.?Results?(1)A total of 1259 premenopausal women were eligible for analysis,among whom 316(25.1%)were <40 years old at diagnosis.Median follow-up time was 64 months,and median age was 44.Compared with older patients,patients <40 years old at diagnosis developed tumors with more unfavorable characteristics,including more triple negative and HER-2 positive breast cancer patients(19.3% vs 17.2%,10.8% vs 8.1%,p<0.001),more grade 3 tumors(45.9% vs 33.8%,p=0.001),more PR negative tumors(47.5% vs 38.1%,p<0.001),more tumors with Ki-67 ?20%(57.6% vs 43.6%,p<0.001)and more chemotherapy treated patients(88.6% vs 76.1%,p<0.001).(2)Age is an independent prognostic factor for 5-year disease free survival in premenopausal breast cancer patients.Women <40 years old at diagnosis showed distinctly inferior DFS compared with patients ? 40 years old(HR,1.6;95% CI,1.1 to 2.2),and the inferiority was most remarkable in patients with luminal-subtype breast cancer(HR,2.0;95%CI,1.3 to 3.2).(3)Age(?40 vs <40:OR=0.2,95%CI:0.1-0.3)and axillary lymph node status of the patients(negative vs positive:OR=0.4,95%CI: 0.2-0.8)may be relevant to the physician's decision on use of OFS.(4)21-gene recurrence score(RS)has relations with tumor histological grade and Ki-67 level: higher tumor grade and Ki-67 level are associated with high RS(grade 3 vs grade 1-2:42.9% vs 16.9%,p=0.003;Ki-67 ?20% vs<20%:35.0% vs 15.3%,p=0.031)?Conclusions?Young age,which is less than 40 years old at diagnosis,predicts worse 5-year disease free survival predominantly in premenopausal patients with luminal subtype breast cancer.Age and axillary lymph node status of the patients may be relevant to the physician's decision on use of OFS.RS is related to tumor grade and Ki-67 level in premenopausal breast cancer patients.