title: Evaluation of Local and Distant Recurrence Patterns in Patients with Triple-Negative Breast Cancer According to Age.
abstract: BACKGROUND
  Triple-negative breast cancer (TNBC) subtype and young patient age are both associated with an increased risk of local recurrence (LR) and distant recurrence (DR). In young women with TNBC, it is unclear whether subtype or patient age is driving prognosis.
  
  
  METHODS
  Patients treated for primary TNBC from 1998 to 2011 were identified from the breast surgery database. Clinicopathologic characteristics, treatment, and outcomes were compared between patients <40 and ≥40 years of age at diagnosis. Multivariate models were used to identify factors independently associated with LR and DR.
  
  
  RESULTS
  Among 1930 patients with TNBC, 289 (15 %) were <40 and 1641 (85 %) were ≥40 years of age at diagnosis. Younger patients were more likely to present with higher stage disease and more likely to receive mastectomy (p < 0.01), axillary node dissection (p < 0.01), and chemotherapy (p < 0.01). At a median follow-up of 74 (0-201.1) months, there was no difference in LR or disease-free survival (DFS) by age group [5-year LR = 3.9 % (95 % confidence interval (CI) 1.5-6.2) vs. 4.5 % (95 % CI 3.5-5.6) and 5-year DFS = 75.3 % (95 % CI 70.2-80.7) vs. 77.7 % (95 % CI 75.6-79.8), p = 0.94] in patients aged <40 and ≥40 years, respectively. On multivariate analysis, larger tumor size, lymphovascular invasion, and nodal positivity were associated with increased risk of DR. Age and type of surgery were not significantly associated with either outcome.
  
  
  CONCLUSIONS
  Young age at diagnosis is not an independent risk factor for LR or DR in patients with TNBC.
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.|Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany.
authors: Julia C
authors: JC
authors: Radosa
authors: Department of Epidemiology-Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Anne
authors: A
authors: Eaton
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Michelle
authors: M
authors: Stempel
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Amrin
authors: A
authors: Khander
authors: Department of Gynecology and Obstetrics, University of Schleswig-Holstein, Lübeck, Germany.
authors: Cornelia
authors: C
authors: Liedtke
authors: Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany.
authors: Erich-Franz
authors: EF
authors: Solomayer
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Maria
authors: M
authors: Karsten
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Melissa
authors: M
authors: Pilewskie
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Monica
authors: M
authors: Morrow
authors: Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA. tking7@partners.org.|Breast Surgery, Brigham and Women's Hospital, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. tking7@partners.org.
authors: Tari A
authors: TA
authors: King
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001365:Axilla; D001808:Blood Vessels / Q000473:pathology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D008408:Mastectomy; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D064726:Triple Negative Breast Neoplasms / Q000473:pathology* / Q000628:therapy*; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents