title: Retrospective analysis of breast cancer prognosis among young and older women in a Brazilian cohort of 738 patients, 1985-2002.
abstract: Invasive breast cancer (BC) is infrequent among women aged ≤40 years, however, the disease outlook in these younger patients is generally worse than among older women. The present study aimed to compare socio-demographic, clinical and pathological characteristics, and their association with long-term survival, between two random cohorts of young (≤40 years) and older (50-69 years) Brazilian patients with BC. The cohort comprised of 738 randomly selected women who were diagnosed with BC at Barretos Cancer Hospital, Pio XII Foundation (Barretos, Brazil) between January 1985 and December 2002; the patients included young women (n=376) and older women (n=362). The current analysis suggested that BC in young women is associated with numerous pathological features of aggressiveness. Second cancer and bilateral BC were independent predictors of a poor outcome in the younger group. Furthermore, C-erB-2 was positively correlated with poor outcome in the older group, whereas estrogen receptor status and TNM stage were associated with disease prognosis in both groups. The overall survival rates of the two age groups were similar except when analyzed according the treatment period (1997-2002). Although patients aged ≤40 years harbored tumors with more aggressive clinicopathological characteristics, these characteristics were not independent predictors of overall survival. The present study indicates that medical advances associated with prevention of breast cancer may improve screening programs, which may therefore increase early diagnosis and subsequently lower mortality rates.
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: De Lima Vazquez
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Thiago Buosi
authors.initials: TB
authors.lastname: Silva
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil; Department of Prevention, Faculty of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
authors.forename: René Aloísio
authors.initials: RA
authors.lastname: Da Costa Vieira
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Allini Mafra
authors.initials: AM
authors.lastname: Da Costa
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Cristovam
authors.initials: C
authors.lastname: Scapulatempo
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: José Humberto Tavares Guerreiro
authors.initials: JH
authors.lastname: Fregnani
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Edmundo Carvalho
authors.initials: EC
authors.lastname: Mauad
authors.affiliation: Laboratory of Medical Investigation 14, Department of Pathology, Medical School of São Paulo University, São Paulo 01246-903, Brazil; 3B's-PT Government Associate Laboratory, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Guimarães, 4710-057 Braga, Portugal; Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil.
authors.forename: Adhemar
authors.initials: A
authors.lastname: Longatto
authors.affiliation: Department of Prevention, Barretos Cancer Hospital, Pio XII Foundation, Barretos, São Paulo 14784-400, Brazil; Department of Clinical Research, Biohit HealthCare Ltd., 00880 Helsinki, Finland.
authors.forename: Kari Juhani
authors.initials: KJ
authors.lastname: Syrjänen
keywords: breast cancer; disease outcome; long-term follow-up; prognostic factors; univariate/multivariate survival analysis; young women