A new retrospective study designed to evaluate the impact of age less than 35 years on breast cancer outcomes has reported that having more than three positive lymph nodes and young age (even among this young group) negatively influence prognosis. The study included 346 women diagnosed with breast cancer between January 1972 and December 2006 at Florence University in Italy. The average age of the women was 32 years (range: 22 to 35); 76 were younger than 30 years old and the remaining 270 were over 30. All were premenopausal.
A total of 215 of the women had breast conserving surgery (lumpectomy or partial mastectomy) followed by whole breast radiotherapy, 131 underwent mastectomy without subsequent radiation treatment, and 323 patients underwent axillary lymph node dissection. A total of 191 of the women were treated with adjuvant chemotherapy, of whom 73 had an anthracycline-containing regimen.
Local recurrences of breast cancer were found in 67 (19.4%) of the women within a median of 2.5 years (range: 6 months to 27.6 years). Having ductal (including ductal plus lobular) rather than lobular tumors, having more than three positive lymph nodes, and young age were found to be independent predictors of recurrence. The authors also conducted an analysis of disease-specific survival, with a median follow-up period of 6.8 years (range: 0.6 to 36.7 years). Young age, positive lymph nodes, and distant metastases were found to be independent predictors of breast cancer death. Patients younger than 30 had a worse prognosis. Local recurrence was also predictive of death. The authors conclude that anthracycline-based chemotherapy appears to improve the outcomes of young breast cancer patients. They comment that there is an urgent need for tailored treatment investigations within the framework of randomized, controlled clinical trials.