The Prognostic Impact of Age at Diagnosis Upon Breast Cancer of Different Immunohistochemical Subtypes: A Surveillance, Epidemiology, and End Results (SEER) Population-Based Analysis

Frontiers in Oncology

Yi Zhou²  Shibin Cai²  Pengpeng Liu²  Shuzheng Chen²  Yin Pan²  Xunxi Lu³  Wenjia Zuo³  Zongchao Gou³ 

[1] Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China;Department of Breast Surgery, Lishui Hospital, Zhejiang University School of Medicine, Lishui, China;Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China;

关键词: breast cancer;    mortality;    immunohistochemical subtype;    age at diagnosis;    prognosis;   

DOI  :  10.3389/fonc.2020.01729

来源: DOAJ

【 摘 要 】

Background and Objectives: The influence of age at diagnosis of breast cancer upon the prognosis of patients with different immunohistochemical (IHC)-defined subtypes is still incompletely defined. Our study aimed at examining the association of age at diagnosis and risk of breast cancer-specific mortality (BCSM).Methods: 172,179 eligible breast cancer patients were obtained for our study cohort using the Surveillance, Epidemiology, and End Results database from 2010 to 2015. Patients were classified into four IHC-defined subtypes according to their ER, PgR, and HER2 status. Kaplan–Meier plots were used to describe BCSM among patients in different age groups. A Cox proportional hazards model was used for multivariate analysis. A multivariable fractional polynomial model within the Cox proportional hazards model was used to evaluate the relationship between age at diagnosis and the risk of BCSM.Results: For the whole cohort, the median follow-up time was 43 months. Patients younger than 40 years and those older than 79 years presented with the worst BCSM (hazard ratio [HR] 1.13, 95% confidence interval [CI] 1.03–1.23, and HR 3.52, 95% CI 3.23–3.83, respectively, p < 0.01, with age 40–49 years as the reference). The log hazard ratios of hormone receptor (HoR)(+)/HER2(–) patients formed a quadratic relationship between age at diagnosis and BCSM, but not in the other three subtypes of breast cancer. In the HoR(+)/HER2(–) subtype, patients younger than 40 years had worse BCSM than those aged at 40–49 years (HR 1.26, 95% CI 1.10–1.45, and p < 0.01).Conclusions: Women diagnosed with HoR(+)/HER2(–) breast cancer younger than 40 years or older than 79 years of age suffer higher rates of cancer-specific mortality. Young age at diagnosis may be particularly prognostic in HoR(+)/HER2(–) breast cancer.

【 授权许可】

Unknown