title: Molecular Subtypes and Prognosis in Young Mexican Women With Breast Cancer.
abstract: Young age represents an adverse prognostic factor in breast cancer (BC), and young women present with more advanced and aggressive disease. In Latin America, BC is increasing in young women, and there is a lack of information regarding the characteristics and outcomes of this patient population.
  
  
  
  We retrospectively analyzed a database of 4315 women treated for BC at a single institution. We compared clinical characteristics, treatment, and survival between women ≤ 40 and > 40 years of age. Survival analyses were performed for each molecular subtype.
  
  
  
  A total of 662 women (15.3%) were ≤ 40 years old. Younger women had more advanced disease, higher grade, and a larger proportion of luminal B and triple-negative tumors (P < .001). At 5 years, both disease-free and overall survival (OS) were lower in younger women, although there were no differences after adjusting for stage. Five-year OS was worse for young women with hormone receptor-positive, human epidermal growth factor receptor 2-negative subtype (82% vs. 87.1%; P = .03), but not for those with human epidermal growth factor receptor 2-positive or triple-negative disease. This difference can be attributed to luminal B tumors, which showed a worse 5-year OS in younger women (79.1% vs. 85.2%; P = .03).
  
  
  
  Although young Mexican patients with BC have more aggressive disease at presentation than older women, only those with luminal B tumors have a worse survival after adjusting for stage. Strategies aimed at downstaging the disease and at improving the treatment of luminal B tumors in this population are needed.
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Centro de Cancer de Mama del Hospital Zambrano Hellion, Tecnologico de Monterrey, Nuevo Leon, Mexico.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Villarreal-Garza
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología e Instituto de Biomédicas, UNAM, Mexico City, Mexico.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mohar
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Juan Enrique
authors.initials: JE
authors.lastname: Bargallo-Rocha
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Federico
authors.initials: F
authors.lastname: Lasa-Gonsebatt
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Nancy
authors.initials: N
authors.lastname: Reynoso-Noverón
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Matus-Santos
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Paula
authors.initials: P
authors.lastname: Cabrera
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Claudia
authors.initials: C
authors.lastname: Arce-Salinas
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lara-Medina
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: Alberto
authors.initials: A
authors.lastname: Alvarado-Miranda
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Ramírez-Ugalde
authors.affiliation: Departamento de Investigacion y de Tumores Mamarios del Instituto Nacional de Cancerologia, Mexico City, Mexico; Cancer Care in the Elderly Clinic, Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. Electronic address: enriquesotopc@yahoo.com.
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto-Perez-de-Celis
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001943:Breast Neoplasms / Q000145:classification / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008800:Mexico; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Age factors; Breast neoplasms; Latin America; Survival; Young women