title: Characteristics and therapy of premenopausal patients with early-onset breast cancer in Germany.
abstract: OBJECTIVE
  The objective of the study is to investigate what kind of tumors young, premenopausal breast cancer patients in Germany show at diagnosis and how they are treated adjuvantly in comparison with a normally distributed cohort.
  
  
  METHODS
  The study describes the data of 535 patients who were treated adjuvantly between 2002 and 2006 and participated in a resident mother-child program for rehabilitation (Groemitz cohort). The data includes TNM categories, biology of tumor and therapies. This population is being compared to an age-heterogeneous cohort from the state of Schleswig-Holstein and the DMP-report of the state of North Rhine-Westphalia.
  
  
  RESULTS
  45.8 % of the patients were diagnosed with tumor category pT1, 37 % pT2, 7.3 % pT3 and 1.9 % pT4. 5 % had merely DCIS. 48.8 % of the patients were pN0, 31.4 % pN1 and 17.4 % had a more intense manifestation of lymph nodes. 43.5 % of the tumors showed a grading classified as G3, 64.3 % were estrogen and progesterone hormone receptor positive and 26.2 % Her2 positive. 21 % of the examined cohort members/patients showed a triple negative carcinoma. 59.1 % of the patients with pT1 underwent breast-conserving surgery, 56.1 % of those with pT2 and 25.6 % of those with pT3. Overall 31.0 % of the women received mastectomy and 14.8 % received mastectomy with subsequent reconstruction. 97.6 % of the patients received axillary surgery, 89.9 % chemotherapy. Overall 23.7 % of the patients received their treatment in connection with clinical studies. 95.3 % of the patients with hormone receptor positive tumor received endocrine therapy, 61.3 % of them with GnRH-analogs. In comparison with the OVIS and DMP cohorts patients of the Groemitz cohort were on average 20 years younger. Their tumors were of bigger size and had more often reached the axillary lymph nodes (pN0 48.8 % Groemitz/62.0 % OVIS/66.7 % DMP). The hormone receptor status was more often negative (35.7/16.6/16.5 %) and tumor grading higher (G3 43.5/29.0/28.5 %). Surgery was more extensive even with small tumors (breast conserving surgery with tumor stage pT1 59.1/81.2/77.6 %) and axillary surgery was performed more often in the young collective (97.6/89.3/62.5 %). More patients of the young collective received chemotherapy (89.9/58.4 %/unknown) and more patients of the young collective with hormone receptor positive tumor received endocrine therapy (95.3/77.4/90.6 %).
  
  
  CONCLUSIONS
  Our study shows that young breast cancer patients in Germany can be regarded as a special group. At the time of diagnosis the tumor has frequently reached a more advanced stage, and carcinomas are more aggressive. Operative and medical treatment will often be more aggressive.
authors.affiliation: Department of Gynecology and Obstetrics, University of Schleswig-Holstein, Campus Lübeck, Ratzeburgerallee 160, 23538 Lübeck, Germany. banzcon@hotmail.com
authors.forename: Constanze
authors.initials: C
authors.lastname: Banz-Jansen
authors.forename: Alessa
authors.initials: A
authors.lastname: Heinrichs
authors.forename: Marianne
authors.initials: M
authors.lastname: Hedderich
authors.forename: Annika
authors.initials: A
authors.lastname: Waldmann
authors.forename: Christine
authors.initials: C
authors.lastname: Dittmer
authors.forename: Berit
authors.initials: B
authors.lastname: Wedel
authors.forename: Imke
authors.initials: I
authors.lastname: Mebes
authors.forename: Klaus
authors.initials: K
authors.lastname: Diedrich
authors.forename: Dorothea
authors.initials: D
authors.lastname: Fischer
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology* / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D005260:Female; D005858:Germany; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D060787:Neoplasm Grading; D017697:Premenopause; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human