title: Breast cancer in young women: Pathologic features and molecular phenotype.
abstract: OBJECTIVE
  Controversy exists about the prognosis of breast cancer in young women. Our objective was to describe clinicopathological and prognostic features to improve adjuvant treatment indications.
  
  
  METHODS
  We conducted a retrospective multi centre study including fifteen French hospitals. Disease-free survival's data, clinical and pathological criteria were collected.
  
  
  RESULTS
  5815 patients were included, 15.6% of them where between 35 and 40 years old and 8.7% below 35. In 94% of the cases, a palpable masse was found in patients ≤35 years old. Triple negative and HER2 tumors were predominantly found in patients ≤35 (22.2% and 22.1%, p < 0.01). A young age ≤40 years (p < 0.001; hazard ratio [HR]: 2.05; 95% confidence limit [CL]: 1.60-2.63) or ≤35 years (p < 0.001; [HR]: 3.86; 95% [CL]: 2.69-5.53) impacted on the indication of chemotherapy. Age ≤35 (p < 0.001; [HR]: 2.01; 95% [CL]: 1.36-2.95) was a significantly negative factor on disease-free survival. Chemotherapy (p < 0.006; [HR]: 0.6; 95% [CL]: 0.40-0.86) and positive hormone receptor status (p < 0.001; [HR]: 0.6; 95% [CL]: 0.54-0.79) appeared to be protector factors. Patients under 36, had a significantly higher rate of local recurrence and distant metastasis compared to patients >35-40 (21.5 vs. 15.4% and 21.8 vs. 12.6%, p < 0.01).
  
  
  CONCLUSIONS
  Young women present a different distribution of molecular phenotypes with more luminal B and triple negative tumors with a higher grade and more lymph node involvement. A young age, must be taken as a pejorative prognostic factor and must play a part in indication of adjuvant therapy.
authors.affiliation: Aix-Marseille University, Marseille, France; Department of Surgical Oncology, Institute Paoli-Calmettes, Marseille, France. Electronic address: laurasabiani@hotmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Sabiani
authors.affiliation: Aix-Marseille University, Marseille, France; Department of Surgical Oncology, Institute Paoli-Calmettes, Marseille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Aix-Marseille University, Marseille, France; Department of Surgical Oncology, Institute Paoli-Calmettes, Marseille, France.
authors.forename: Mellie
authors.initials: M
authors.lastname: Heinemann
authors.affiliation: Department of Surgical Oncology, Curie Institute, Paris, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Reyal
authors.affiliation: Department of Surgical Oncology, West Cancer Institute, Nantes, France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Classe
authors.affiliation: Department of Surgical Oncology, Institute Paoli-Calmettes, Marseille, France; Department of Surgical Oncology, Casamance Hospital, Aubagne, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Department of Surgical Oncology, Gustave Roussy Institute, Villejuif, France.
authors.forename: Jean Rémy
authors.initials: JR
authors.lastname: Garbay
authors.affiliation: Department of Surgical Oncology, Oscar Lambret Centre, Lille, France.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Giard
authors.affiliation: Department of Surgical Oncology, Claudius Regaud Institute, Toulouse, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Charitansky
authors.affiliation: Department of Surgical Oncology, Léon Bérard Centre, Lyon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Chopin
authors.affiliation: Department of Surgical Oncology, René Huguenin Centre, Saint-Cloud, France.
authors.forename: Roman
authors.initials: R
authors.lastname: Rouzier
authors.affiliation: Department of Surgical Oncology, Tenon Hospital, Paris, France.
authors.forename: Emile
authors.initials: E
authors.lastname: Daraï
authors.affiliation: Department of Surgical Oncology, Georges-François Leclerc Centre, Dijon, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Coutant
authors.affiliation: Department of Surgical Oncology, Grasse Hospital, Grasse, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Azuar
authors.affiliation: Department of Surgical Oncology, Jean Perrin Centre, Clermont-Ferrand, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Gimbergues
authors.affiliation: Deaconess Hospital, Paris, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Villet
authors.affiliation: Department of Surgical Oncology, Bergonié Institute, Bordeaux, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Tunon de Lara
authors.affiliation: Aix-Marseille University, Marseille, France; Department of Surgical Oncology, Institute Paoli-Calmettes, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Lambaudie
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D010641:Phenotype; D011379:Prognosis; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Disease-free survival; HER2 over expression; Invasive ductal carcinoma; Molecular phenotype; Young women