title: Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer.
abstract: OBJECTIVE
  This analysis was performed to clarify the relationship of young age at diagnosis to the pathologic features of the tumor and prognosis in patients with early-stage breast cancer.
  
  
  METHODS
  We retrospectively analyzed data from 1,398 patients with American Joint Committee on Cancer Staging stage I or II breast cancer treated by breast-conserving therapy between 1968 and 1985. One hundred seven patients were younger than 35 years at the time of diagnosis. The median follow-up duration for the 1,032 survivors was 99 months.
  
  
  RESULTS
  Patients younger than 35 years had a significantly higher overall recurrence rate (P = .002), as well as a greater risk for developing distant metastases (P = .03), when compared with older patients. The cancers in younger patients more commonly showed factors associated with a worse prognosis (including grade 3 histology, lymphatic vessel invasion [LVI], necrosis, and estrogen receptor [ER] negativity) as compared with older patients. In a proportional hazards model that included clinical and treatment-related variables, as well as these pathologic features, age younger than 35 years remained a significant predictor for time to recurrence (relative risk [RR], 1.70), time to distant failure (RR, 1.60), and overall mortality (RR, 1.50).
  
  
  CONCLUSIONS
  Breast cancer patients younger than 35 years have a worse prognosis than older patients. This difference is only partially explained by a higher frequency of adverse pathologic factors seen in younger patients.
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Nixon
authors.forename: D
authors.initials: D
authors.lastname: Neuberg
authors.forename: D F
authors.initials: DF
authors.lastname: Hayes
authors.forename: R
authors.initials: R
authors.lastname: Gelman
authors.forename: J L
authors.initials: JL
authors.lastname: Connolly
authors.forename: S
authors.initials: S
authors.lastname: Schnitt
authors.forename: A
authors.initials: A
authors.lastname: Abner
authors.forename: A
authors.initials: A
authors.lastname: Recht
authors.forename: F
authors.initials: F
authors.lastname: Vicini
authors.forename: J R
authors.initials: JR
authors.lastname: Harris
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000367:Age Factors; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis