title: The impact of young age on breast cancer outcome.
abstract: OBJECTIVE
  We conducted a retrospective analysis in order to evaluate the impact of age on women aged less than 35 years affected by breast cancer.
  
  
  METHODS
  Between January 1972 and December 2006, 346 patients aged less than 35 years underwent adjuvant treatment at Florence University. The mean age of the patient population was 32 years (range 22-35): 76 patients were under 30 years old, the remaining were above 30 years old.
  
  
  RESULTS
  In our series, 215 patients received adjuvant radiotherapy to whole breast after conservative surgery, 131 patients underwent mastectomy without subsequent radiation therapy and 323 patients had lymphadenectomy; 191 patients received adjuvant chemotherapy, 73 with anthracycline-containing regimen. With a median time of 2.5 years (range 6 months to 27.6 years) local relapses were observed in 67 cases (19.4%). At the multivariate analysis of local disease-free survival, ductal and ductal plus lobular histotypes, having more than 3 positive nodes, and age emerged as independent significant relapse predictors (p = 0.018, p = 0.0005, p = 0.003 and p = 0.024, respectively). For the DSS analysis, the median follow-up was 6.8 years (range 0.6-36.7 years). At the multivariate analysis, age (p = 0.0038), positive nodes (p = 0.0035) and distant metastases (p < 0.0001) resulted to be independent death predictors. Patients younger than 30 had a worse prognosis. At the univariate analysis also local relapse resulted to be statistically significant (p = 0.0004).
  
  
  CONCLUSIONS
  Anthracycline-based chemotherapy seems to improve the outcome of these patients. However, there is an urgent need for tailored treatment investigations within the framework of randomized, controlled clinical trials.
authors.affiliation: Department of Radiation-Oncology, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Livi
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.forename: C
authors.initials: C
authors.lastname: Saieva
authors.forename: S
authors.initials: S
authors.lastname: Borghesi
authors.forename: V
authors.initials: V
authors.lastname: Scotti
authors.forename: A
authors.initials: A
authors.lastname: Petrucci
authors.forename: A
authors.initials: A
authors.lastname: Rampini
authors.forename: L
authors.initials: L
authors.lastname: Marrazzo
authors.forename: V
authors.initials: V
authors.lastname: Di Cataldo
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
authors.forename: L
authors.initials: L
authors.lastname: Cataliotti
authors.forename: G
authors.initials: G
authors.lastname: Biti
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000704:Analysis of Variance; D018943:Anthracyclines / Q000008:administration & dosage; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008408:Mastectomy; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018943:Anthracyclines