Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland

Giacomo Montagna¹, Robin Schaffar², Andrea Bordoni³, Alessandra Spitale³, Daniela A Terribile^{4

5}, Lorenzo Rossi^{6

7}, Yvan Bergeron⁸, Bernadette W A van der Linden^{8

9}, Isabelle Konzelmann¹⁰, Sabine Rohrmann¹¹, Katharina Staehelin¹², Manuela Maspoli-Conconi¹³, Jean-Luc Bulliard^{13

14}, Francesco Meani^{7

15}, Olivia Pagani^{7

16

17}, Elisabetta Rapiti²

Affiliations

¹ Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10001, USA.
² Geneva Cancer Registry, University of Geneva, 1205 Geneva, Switzerland.
³ Ticino Cancer Registry, Cantonal Institute of Pathology, 6600 Locarno, Switzerland.
⁴ Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
⁵ Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
⁶ Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland.
⁷ Breast Unit of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.
⁸ Fribourg Cancer Registry, 1705 Fribourg, Switzerland.
⁹ Population Health Laboratory (#PopHealthLab), University of Fribourg, 1705 Fribourg, Switzerland.
¹⁰ Valais Health Observatory (OVS), 1950 Sion, Switzerland.
¹¹ Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, 8091 Zurich, Switzerland.
¹² Basel Cancer Registry, 4001 Basel, Switzerland.
¹³ Neuchâtel and Jura Cancer Registry, 2000 Neuchâtel, Switzerland.
¹⁴ Vaud Cancer Registry, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland.
¹⁵ Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland.
¹⁶ Geneva University Hospitals, 1205 Geneva, Switzerland.
¹⁷ Swiss Group for Clinical Cancer Research (SAKK), 6500 Bellinzona, Switzerland.

PMID: 35267635
PMCID: PMC8909610
DOI: 10.3390/cancers14051328

Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland

Giacomo Montagna et al. Cancers (Basel). 2022.

. 2022 Mar 4;14(5):1328.

doi: 10.3390/cancers14051328.

Authors

Affiliations

¹ Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10001, USA.
² Geneva Cancer Registry, University of Geneva, 1205 Geneva, Switzerland.
³ Ticino Cancer Registry, Cantonal Institute of Pathology, 6600 Locarno, Switzerland.
⁴ Dipartimento di Scienze Mediche e Chirurgiche, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
⁵ Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
⁶ Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland.
⁷ Breast Unit of Southern Switzerland, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland.
⁸ Fribourg Cancer Registry, 1705 Fribourg, Switzerland.
⁹ Population Health Laboratory (#PopHealthLab), University of Fribourg, 1705 Fribourg, Switzerland.
¹⁰ Valais Health Observatory (OVS), 1950 Sion, Switzerland.
¹¹ Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, 8091 Zurich, Switzerland.
¹² Basel Cancer Registry, 4001 Basel, Switzerland.
¹³ Neuchâtel and Jura Cancer Registry, 2000 Neuchâtel, Switzerland.
¹⁴ Vaud Cancer Registry, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 1010 Lausanne, Switzerland.
¹⁵ Department of Obstetrics and Gynecology, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland.
¹⁶ Geneva University Hospitals, 1205 Geneva, Switzerland.
¹⁷ Swiss Group for Clinical Cancer Research (SAKK), 6500 Bellinzona, Switzerland.

PMID: 35267635
PMCID: PMC8909610
DOI: 10.3390/cancers14051328

Abstract

Background: An increase in breast cancer (BC) incidence in young women (YW) as well as disparities in BC outcomes have been reported in Switzerland. We sought to evaluate treatment and outcome differences among YW with BC (YWBC). Methods: YW diagnosed with stage I-III BC between 2000−2014 were identified through nine cancer registries. Concordance with international guidelines was assessed for 12 items covering clinical/surgical management, combined in a quality-of-care score. We compared score and survival outcome between the two linguistic-geographic regions of Switzerland (Swiss-Latin and Swiss-German) and evaluated the impact of quality-of-care on survival. Results: A total of 2477 women were included. The median age was 37.3 years (IQR 34.0−39.4 years), with 50.3% having stage II BC and 70.3% having estrogen receptor positive tumors. The mean quality-of-care score was higher in the Latin region compared to the German region (86.0% vs. 83.2%, p < 0.0005). Similarly, 5- and 10-year overall survival rates were higher in the Latin compared to the German region (92.3% vs. 90.2%, p = 0.0593, and 84.3% vs. 81.5%, p = 0.0025, respectively). There was no difference in survival according to the score. In the univariate analysis, women in the Latin region had a 28% lower mortality risk compared to women in the German region (hazard ratio 0.72; 95% CI 0.59−0.89). In the multivariable analysis, only stage, differentiation, tumor subtype and treatment period remained independently associated with survival. Conclusions: We identified geographic disparities in the treatment and outcome of YWBC in Switzerland. National guidelines for YWBC should be implemented to standardize treatment. Awareness should be raised among YW and clinicians that BC does not discriminate by age.

Keywords: Switzerland; breast cancer; management; outcome; young women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
**Swiss regions (cantons) participating in the study.** Swiss-Latin cantons, including Swiss-Italian and Swiss-French, are depicted in yellow. Swiss-German cantons are depicted in red.

**Figure 2**
Kaplan–Meier estimates for overall survival of young women with breast cancer treated between 2000 and 2014 in Switzerland.

See this image and copyright information in PMC

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Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland

Affiliations

Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources