title: The Prognostic Impact of Molecular Subtypes and Very Young Age on Breast Conserving Surgery in Early Stage Breast Cancer.
abstract: BACKGROUND
  Premenopausal breast cancer with a triple-negative phenotype (TNBC) has been associated with inferior locoregional recurrence free survival (LRFS) and overall survival (OS) after breast conserving surgery (BCS). The aim of this study is to analyze the association between age, subtype, and surgical treatment on survival in young women (≤40 years) with early breast cancer in a population with a high rate of breast cancer in young women.
  
  
  METHODS
  Three hundred thirty-two patients ≤40 years old with stage I-II invasive breast cancer who underwent surgery at a single institution between 1998 and 2012 were identified retrospectively. Uni- and multivariate analysis evaluated predictors of LRFS, OS, and disease free survival (DFS).
  
  
  RESULTS
  Most patients (64.2%) underwent BCS. Mean age and follow-up time were 35 (25 ± 3.61) years, and 72 months (range, 24-252), respectively. In multivariate analysis, multicentricity/multifocality and young age (<35 years) independently predicted for poorer DFS and OS. Those aged 35-40 years had higher LRFS and DFS than those <35 in the mastectomy group (p=0.007 and p=0.039, respectively). Patients with TNBC had lower OS compared with patients with luminal A subtype (p=0.042), and those who underwent BCS had higher OS than patients after mastectomy (p=0.015).
  
  
  CONCLUSIONS
  Young age (< 35 years) is an independent predictor of poorer OS and DFS as compared with ages 35-40, even in countries with a lower average age of breast cancer presentation. In addition, TNBC in the young predicts for poorer OS. BCS can be performed in young patients with TNBC, despite their poorer overall survival.
authors.affiliation: Medical Oncology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Cetin
authors.initials: C
authors.lastname: Ordu
authors.affiliation: General Surgery, University of North Carolina at Chapel Hill.
authors.forename: Kandace
authors.initials: K
authors.lastname: McGuire
authors.affiliation: Radiation Oncology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Gul
authors.initials: G
authors.lastname: Alco
authors.affiliation: Medical Oncology, Istanbul Bilim University.
authors.forename: Kezban
authors.initials: K
authors.lastname: Nur Pilanci
authors.affiliation: Medical Oncology, Istanbul Bilim University.
authors.forename: Ulkuhan I
authors.initials: UI
authors.lastname: Koksal
authors.affiliation: Radiology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Filiz
authors.initials: F
authors.lastname: Elbüken
authors.affiliation: Physical Therapy and Rehabilitation, Istanbul Bilim University.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Erdogan
authors.affiliation: Radiology, Istanbul Florence Nightingale Hospital.
authors.forename: Filiz
authors.initials: F
authors.lastname: Agacayak
authors.affiliation: General Surgery, Istanbul Florence Nightingale Hospital.
authors.forename: Serkan
authors.initials: S
authors.lastname: Ilgun
authors.affiliation: General Surgery, Istanbul Florence Nightingale Hospital.
authors.forename: Dauren
authors.initials: D
authors.lastname: Sarsenov
authors.affiliation: General Surgery, Istanbul Florence Nightingale Hospital.
authors.forename: Alper
authors.initials: A
authors.lastname: Öztürk
authors.affiliation: Radiation Oncology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Şefik
authors.initials: Ş
authors.lastname: İğdem
authors.affiliation: Radiation Oncology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Sait
authors.initials: S
authors.lastname: Okkan
authors.affiliation: Medical Oncology, Istanbul University/Oncology Institute.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Eralp
authors.affiliation: Radiation Oncology, Gayrettepe Florence Nightingale Hospital.
authors.forename: Maktav
authors.initials: M
authors.lastname: Dincer
authors.affiliation: Department of Surgery, Istanbul University.
authors.forename: Vahit
authors.initials: V
authors.lastname: Ozmen
keywords: breast cancer; breast conserving surgery; molecular subtypes; survival; young age