title: Young age as an adverse prognostic factor in premenopausal women with operable breast cancer.
abstract: Data regarding young age as an independent prognostic factor have been conflicting. We investigated this variable in 696 premenopausal Vietnamese and Chinese women with operable breast cancer who participated in a clinical trial of adjuvant surgical oophorectomy and tamoxifen. Tumor size and axillary lymph node status did not vary with age. Women < 35 years had a greater fraction of histologic grade III tumors (P = 0.06), and in the two thirds of patients with available data, in women < 35 years, there was a lower percentage of estrogen- and progesterone receptor-positive tumors and a higher percentage of HER2/neu-positive tumors (P > 0.14 for each group). In univariate analyses, compared to women > or = 45 years, women < 35 years and 35-39 years were at greater risk for death (P = 0.002 and P = 0.023, respectively), and compared to women > or = 40, women < 40 were at greater risk of death (P = 0.002). Multivariate analyses supported a conclusion that younger age was an independent adverse prognostic factor for survival (P = 0.005, age as a continuous variable). Kaplan-Meier analyses in all patients and in oophorectomy and tamoxifen-treated patients, but not in observation-only patients, showed statistically significant poorer disease-free and overall survival in women < 40 years compared to those > or = 40 years. Thus, despite efficacy of the combined adjuvant hormonal therapy, younger age was a risk factor for poorer survival.
authors.affiliation: Department of Medicine, University of Wisconsin, University of Wisconsin Comprehensive Cancer Center, Madison, USA. rrlove@facstaff.wisc.edu
authors.forename: Richard R
authors.initials: RR
authors.lastname: Love
authors.forename: Nguyen Ba
authors.initials: NB
authors.lastname: Duc
authors.forename: Nguyen Van
authors.initials: NV
authors.lastname: Dinh
authors.forename: Tran Tu
authors.initials: TT
authors.lastname: Quy
authors.forename: Ye
authors.initials: Y
authors.lastname: Xin
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Havighurst
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000704:Analysis of Variance; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000401:mortality* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D010052:Ovariectomy; D017697:Premenopause; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D016019:Survival Analysis; D013629:Tamoxifen / Q000627:therapeutic use*; D016896:Treatment Outcome; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D013629:Tamoxifen