Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2007 Dec 5:7:222.
doi: 10.1186/1471-2407-7-222.

Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: the Saudi Arabia experience

Naser Elkum  1 , Said Dermime, Dahish Ajarim, Ali Al-Zahrani, Adher Alsayed, Asma Tulbah, Osama Al Malik, Mohamed Alshabanah, Adnan Ezzat, Taher Al-Tweigeri
Affiliations
Comparative Study

Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: the Saudi Arabia experience

Naser Elkum et al. BMC Cancer. .

Abstract

Background: Breast cancer in young Saudi women is a crucial problem. According to the 2002 annual report of Saudi National Cancer Registry, breast cancers that developed before the age of 40 comprise 26.4% of all female breast cancers comparing to 6.5% in the USA. Breast cancer in young patients is often associated with a poorer prognosis, but there has been a scarcity of published data in the Middle East population.

Methods: Total of 867 breast cancer patients seen at King Faisal Specialist Hospital & Research Centre (KFSH&RC) between 1986 and 2002 were reviewed. Patients were divided in two age groups: < or = 40 years and above 40 years. The clinicopathological characteristics and treatment outcomes were compared between younger and older age groups.

Results: Median age at presentation was 45 years. A total of 288 (33.2%) patients were aged < or = 40 years. Hormone receptors were positive in 69% of patients 40 and 78.2% of patients above 40 (p = 0.009). There was a significantly higher incidence of grade III tumor in younger patients compared to older patients (p = 0.0006). Stage, tumor size, lymphatic/vascular invasion, number of nodes and axillary lymph node status, did not differ significantly between the two age groups. Younger patients had a greater probability of recurrence at all time periods (p = 0.035). Young age had a negative impact on survival of patients with positive axillary lymph nodes (p = 0.030) but not on survival of patients with negative lymph nodes (p = 0.695). Stage, tumor size, nodal status and hormonal receptors had negative impact on survival. Adjuvant chemotherapy was administered to 87.9% of younger and 65.6% of older patients (p < 0.0001). In terms of hormone therapy, the proportion of tamoxifen treated patients was significantly lower in young age group (p < 0.0001). No significant difference in radiation therapy between the two groups.

Conclusion: Young age (< or = 40) is an independent risk factor for relapse in operable Saudi breast cancer patients. The fundamental biology of young age breast cancer patients needs to be elucidated.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Stratified analysis of survival of breast cancer between the two age groups (≤ 40, and above 40): Patients with operable breast cancer below the age of 40 had a worse survival than the group above age 40.
Figure 2
Figure 2
Kaplan-Meier survival analysis of patients with positive axillary lymph nodes and effects on survival stratified by age groups ≤ 40 years, and above 40 years. Patients with positive axillary lymph nodes and young age have worst survival. (P = 0.030).
See this image and copyright information in PMC

References

    1. Tarone RE. Breast cancer trends among young women in the United States. Epidemiology (Cambridge, Mass) 2006;17:588–590. - PubMed
    1. Registry NC. Cancer Incidence Report Saudi Arabia 2002. Riyadh. 2007.
    1. Zabicki K, Colbert JA, Dominguez FJ, Gadd MA, Hughes KS, Jones JL, Specht MC, Michaelson JS, Smith BL. Breast cancer diagnosis in women < or = 40 versus 50 to 60 years: increasing size and stage disparity compared with older women over time. Ann Surg Oncol. 2006;13:1072–1077. doi: 10.1245/ASO.2006.03.055. - DOI - PubMed
    1. Bollet MA, Sigal-Zafrani B, Mazeau V, Savignoni A, de la Rochefordiere A, Vincent-Salomon A, Salmon R, Campana F, Kirova YM, Dendale R, et al. Age remains the first prognostic factor for loco-regional breast cancer recurrence in young (<40 years) women treated with breast conserving surgery first. Radiother Oncol. 2007;82:272–280. doi: 10.1016/j.radonc.2007.01.001. - DOI - PubMed
    1. Aryandono T, Harijadi , Soeripto Breast cancer in young women: prognostic factors and clinicopathological features. Asian Pac J Cancer Prev. 2006;7:451–454. - PubMed

Publication types

MeSH terms