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
Multicenter Study
. 2023 Apr:68:163-172.
doi: 10.1016/j.breast.2023.02.004. Epub 2023 Feb 8.

Early breast cancer in women aged 35 years or younger: A large national multicenter French population-based case control-matched analysis

Ondine Dufour  1 , Gilles Houvenaeghel  2 , Jean-Marc Classe  3 , Monique Cohen  2 , Christelle Faure  4 , Chafika Mazouni  5 , Marie-Pierre Chauvet  6 , Eva Jouve  7 , Emile Darai  8 , Anne-Sophie Azuar  9 , Pierre Gimbergues  10 , Anthony Gonçalves  1 , Alexandre de Nonneville  11
Affiliations
Multicenter Study

Early breast cancer in women aged 35 years or younger: A large national multicenter French population-based case control-matched analysis

Ondine Dufour et al. Breast. 2023 Apr.

Abstract

Background: There is a scarcity of data exploring early breast cancer (eBC) in very young patients. We assessed shared and intrinsic prognostic factors in a large cohort of patients aged ≤35, compared to a control group aged 36 to 50.

Methods: Patients ≤50 were retrospectively identified from a multicentric cohort of 23,134 eBC patients who underwent primary surgery between 1990 and 2014. Multivariate Cox analyses for DFS and OS were built. To assess the independent impact of age, 1 to 3 case-control analysis was performed by matching ≤35 and 36-50 years patients.

Results: Of 6481 patients, 556 were aged ≤35, and 5925 from 36 to 50. Age ≤35 was associated with larger tumors, higher grade, ER-negativity, macroscopic lymph node involvement (pN + macro), lymphovascular invasion (LVI), mastectomy, and chemotherapy (CT) use. In multivariate analysis, age ≤35 was associated with worse DFS [HR 1.56, 95% CI 1.32-1.84; p < 0.001], and OS [HR 1.29, 95% CI 1.03-1.60; p = 0.025], as were high grade, large tumor, LVI, pN + macro, ER-negativity, period of diagnostic, and absence of ET or CT (for DFS). Adverse prognostic impact of age ≤35 was maintained in the case control-matched analysis for DFS [HR 1.56, 95%CI 1.28-1.91, p < 0.001], and OS [HR 1.33, 95%CI 1.02-1.73, p = 0.032]. When only considering patients ≤35, ER, tumor size, nodal status, and LVI were independently associated with survival in this subgroup.

Conclusions: Age ≤35 is associated with less favorable presentation and more aggressive treatment strategies. Our results support the poor prognosis value of young age, which independently persisted when adjusting for other prognostic factors and treatments.

Keywords: Early breast cancer; Impact of age; Prognostic of young age; Under 35 years old; Very young patient; Young breast cancer.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest Alexandre de Nonneville declares Gilead (lecture fees, congress invitations), Daiichi Sankyo (lecture fees, congress invitations), Seagen (consulting fees), Lilly (lecture fees, congress invitations, consulting fees, research grants paid to institution), Novartis (consulting fees), MSD (congress invitations, lecture fees), Pfizer (research grants paid to institution). No conflict of interest declared by others authors.

Figures

Fig. 1
Fig. 1
Flow chart of the population.
Fig. 2
Fig. 2
Kaplan Meier of univariate analysis of DFS (A) and OS (B) in both cohorts.
Fig. 3
Fig. 3
Kaplan Meier of univariate analysis of DFS (A) and OS (B) in the matched population.
Fig. 4
Fig. 4
Impact of young age on DFS and OS: summary of Hazard Ratio by Forest plot.
Fig. 5
Fig. 5
Kaplan Meier of univariate analysis of DFS (A) and OS (B) in the <35 cohort according to endocrine receptors.
Fig. 6
Fig. 6
Kaplan Meier of univariate analysis of DFS (A) and OS (B) in the <35 cohort according to molecular subtype.
See this image and copyright information in PMC

References

    1. Siegel R.L., Miller K.D., Fuchs H.E., Jemal A. Cancer statistics, 2021. Ca - Cancer J Clin. 2021;71(1):7–33. - PubMed
    1. Sung H., Ferlay J., Siegel R.L., Laversanne M., Soerjomataram I., Jemal A., et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Ca - Cancer J Clin. 2021;71(3):209–249. - PubMed
    1. Nixon A.J., Neuberg D., Hayes D.F., Gelman R., Connolly J.L., Schnitt S., et al. Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer. J Clin Oncol Off J Am Soc Clin Oncol. mai. 1994;12(5):888–894. - PubMed
    1. de la Rochefordiere A., Asselain B., Campana F., Scholl S.M., Fenton J., Vilcoq J.R., et al. Age as prognostic factor in premenopausal breast carcinoma. Lancet Lond Engl. 24 avr. 1993;341(8852):1039–1043. - PubMed
    1. Albain K.S., Allred D.C., Clark G.M. Breast cancer outcome and predictors of outcome: are there age differentials? J Natl Cancer Inst Monogr. 1994;(16):35–42. - PubMed

Publication types