title: Young Age Is Associated with Increased Locoregional Recurrence in Node-Positive Breast Cancer with Luminal Subtypes.
abstract: OBJECTIVE
  The effects of biological subtypes within breast cancer on prognosis are influenced by age at diagnosis. We investigated the association of young age with locoregional recurrence (LRR) between patients with luminal subtypes versus those with nonluminal subtypes.
  
  
  METHODS
  Medical records of 524 breast cancer patients with positive lymph nodes between 1999 and 2010 were reviewed retrospectively. All patients received curative surgery and adjuvant chemotherapy based on contemporary guidelines. Radiation was delivered for patients who underwent breast conserving surgery or those who had four or more positive lymph nodes after mastectomy. Adjuvant hormone therapy was administered to 413 patients with positive hormone receptors according to their menstrual status.
  
  
  RESULTS
  During median follow-up of 84 months, the 10-year locoregional recurrence-free survival rate (LRRFS) was 84.3% for all patients. Patients < 40 years showed significantly worse 10-year LRRFS than those ≥ 40 years (73.2% vs. 89.0%, respectively; p=0.01). The negative effect of young age on LRRFS was only observed in luminal subtypes (69.7% for < 40 years vs. 90.8% for ≥ 40 years; p < 0.01). Multivariate analysis using luminal subtypes ≥ 40 years as a reference revealed luminal subtypes < 40 years were significantly associated with increased risk of LRR (hazard ratio, 2.33; p < 0.01).
  
  
  CONCLUSIONS
  Young breast cancer patients with positive lymph nodes had a higher risk of LRR than those aged ≥ 40 years. This detrimental effect of young age on LRR was confined in luminal subtypes.
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Mison
authors.initials: M
authors.lastname: Chun
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Sehwan
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Yong Sik
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Jin Hyuk
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seok Yun
authors.initials: SY
authors.lastname: Kang
authors.affiliation: Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Hyunee
authors.initials: H
authors.lastname: Yim
authors.affiliation: Department of Radiation Oncology, Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea.
authors.forename: Seung Hee
authors.initials: SH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor
keywords: Age factors; Breast neoplasms; Local neoplasm recurrence