Multifocal breast cancer in women < or =35 years old.
BACKGROUND
The relation that multifocality at diagnosis had to survival in women < 35 years of age was evaluated.


METHODS
Three hundred women seen at the M. D. Anderson Cancer Center between 1990 and 2002 were identified. Multifocality was defined as the presence of 2 or more foci of the same tumor clearly separated in the same breast. Patient characteristics and outcomes were tabulated and compared between uni- and multifocality. Survival outcomes were estimated with the Kaplan-Meier product limit method and compared between groups with the log-rank statistic. Cox proportional hazards models were fit to determine the association between multifocality and survival outcomes.


RESULTS
The median age was 32 years (range, 17-35). There were 58 patients (19%) with multifocal disease. At a median follow-up of 43.9 months there have been 101 deaths and 138 recurrences. Five-year overall survival (OS) estimates were 69.7% (95% confidence interval [CI], 63.1%, 77.1%) for patients with unifocal disease and 67.3% (95% CI, 54.6%, 83.0%) for patients with multifocal disease (P = .70). Five-year recurrence-free survival (RFS) was 44.4% (95% CI, 37.1%, 53.2%) for patients with unifocal disease and 57.1% (5% CI, 43.3%, 75.4%) for patients with multifocal disease, (P = .36). Nuclear grade was found to be an independent predictor of OS and RFS (hazard ratio [HR], 2.92, 95% CI, 1.24-6.87; HR, 2.09, 95% CI, 1.13-3.83, respectively).


CONCLUSIONS
Multifocality does not appear to influence prognosis in patients < 35 years of age. Nuclear grade continues to be an important prognostic factor for breast cancer in this age group.
Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. jlitton@mdanderson.org
Jennifer K
JK
Litton
Yesim
Y
Eralp
Ana M
AM
Gonzalez-Angulo
Kristine
K
Broglio
Anne
A
Uyei
Gabriel N
GN
Hortobagyi
Banu
B
Arun
D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012720:Severity of Illness Index