title: Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease.
abstract: BACKGROUND
  There is limited knowledge about prognosis, and treatment effects in young women with node-negative disease.
  
  
  METHODS
  We evaluated biological features, treatment recommendations and prognosis for 841 premenopausal patients with pT1-3, pN0 and M0, operated from 1997 to 2001.
  
  
  RESULTS
  Patients below 35 years (101, 12%) were more likely to have tumors > 2 cm (35.6% versus 24.2%, P = 0.002), grade 3 (48.5% versus 31.9%, P = 0.009) and with elevated Ki-67 expression (62.4% versus 50.7%, P = 0.002). At the multivariate analysis a statistically significant difference in disease-free survival (DFS, HR 4.44; 95% CI 2.53 to 7.78, P < 0.0001), risk of distant metastases (DDFS) (HR 3.23; 95% CI 1.32 to 7.94, P = 0.011) and overall survival (OS) (HR 2.89; 95% CI 1.06 to 7.87, P = 0.038) was observed for younger versus older patients and in the subgroup with endocrine responsive tumors (DFS, HR 5.17, 95% CI 2.72-9.83, P = < 0.0001; DDFS, 3.76, 95% CI 1.33-10.6, P = 0.013; OS, 4.71, 95% CI 1.09-20.4, P = 0.039 ).
  
  
  CONCLUSIONS
  Compared with less young, very young patients with endocrine responsive and node-negative breast cancer have a worse prognosis. Tailored treatments should be explored in this cohort of patients.
authors.affiliation: Research Unit in Medical Senology, Department of Medicine, Instituto Europeo di Oncologia, Milan, Italy. marco.colleoni@ieo.it
authors.forename: M
authors.initials: M
authors.lastname: Colleoni
authors.forename: N
authors.initials: N
authors.lastname: Rotmensz
authors.forename: G
authors.initials: G
authors.lastname: Peruzzotti
authors.forename: P
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: L
authors.initials: L
authors.lastname: Orlando
authors.forename: R
authors.initials: R
authors.lastname: Ghisini
authors.forename: G
authors.initials: G
authors.lastname: Viale
authors.forename: G
authors.initials: G
authors.lastname: Pruneri
authors.forename: P
authors.initials: P
authors.lastname: Veronesi
authors.forename: A
authors.initials: A
authors.lastname: Luini
authors.forename: M
authors.initials: M
authors.lastname: Intra
authors.forename: A
authors.initials: A
authors.lastname: Cardillo
authors.forename: R
authors.initials: R
authors.lastname: Torrisi
authors.forename: A
authors.initials: A
authors.lastname: Rocca
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D002277:Carcinoma / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D015999:Multivariate Analysis; D017697:Premenopause; D011379:Prognosis
chemical_list: D018931:Antineoplastic Agents, Hormonal