title: Young age is associated with ipsilateral breast tumor recurrence after breast conserving surgery and radiation therapy in patients with HER2-positive/ER-negative subtype.
abstract: Young breast cancer patients are more likely than old patients to experience ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS). However, the pathological processes underlying this relationship have not been elucidated. We investigated the effect of young age on IBTR in a Korean cohort of women with different molecular subtypes of breast cancer. We analyzed data of 2,102 consecutive breast cancer patients who underwent BCS and post-surgical radiation therapy (RT) at two Korean institutions between 2000 and 2005. Patients were classified as young (≤ 40 years; N = 513) or old (> 40 years; N = 1,589). Breast cancer subtype was determined by estrogen receptor (ER), progesterone receptor (PR), and HER2. Median follow-up duration was 61 months. The 5-year IBTR rate was 3.4% in young patients and 1.1% in old patients (P < 0.001). Univariate analysis indicated that IBTR rate in young patients with luminal A and HER2 subtypes was significantly greater than in old patients with these subtypes (P = 0.015 and P < 0.001, respectively). Multivariate analysis, which used luminal A subtype in old patients as reference, indicated that HER2 subtype in young patients was associated with increased risk of IBTR (hazard ratio, HR = 12.24; 95% CI: 2.54-57.96). Among old patients, HER2 subtype was not associated with increased IBTR. In conclusion, young women had a higher rate of IBTR after BCS and RT than old women. This difference is mainly among women with HER2 subtype. Aggressive local control and adjuvant therapy should be considered for young women with HER2 subtype breast cancer.
authors.affiliation: Department of Surgery, College of Medicine, Asan Medical Center, 388 Pungnap-dong, Songpa-gu, Seoul 137-737, Korea.
authors.forename: Hee Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Wonshik
authors.initials: W
authors.lastname: Han
authors.forename: On Vox
authors.initials: OV
authors.lastname: Yi
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Shin
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Ahn
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Koh
authors.forename: Hyeong-Gon
authors.initials: HG
authors.lastname: Moon
authors.forename: Jong Han
authors.initials: JH
authors.lastname: You
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Sei Hyun
authors.initials: SH
authors.lastname: Ahn
authors.forename: Dong-Young
authors.initials: DY
authors.lastname: Noh
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000378:metabolism / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007723:Korea; D015412:Mastectomy, Segmental; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism; D046888:Tissue Array Analysis
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human