Breast Cancer (Dove Med Press). 2017 Jun 10;9:407-414. doi: 10.2147/BCTT.S130273. eCollection 2017.
Younger age is an independent predictor of worse prognosis among Lebanese nonmetastatic breast cancer patients: analysis of a prospective cohort.
Breast cancer (Dove Medical Press)
Alissar El Chediak, Raafat S Alameddine, Ayman Hakim, Lara Hilal, Sarah Abdel Massih, Lana Hamieh, Deborah Mukherji, Sally Temraz, Maya Charafeddine, Ali Shamseddine
Affiliations
Affiliations
- Division of Hematology/Oncology, Department of Internal Medicine.
- Department of Radiation Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
- Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, USA.
PMID: 28670139
PMCID: PMC5479304 DOI: 10.2147/BCTT.S130273
Abstract
BACKGROUND: Several retrospective studies have reported that younger age at presentation is associated with a worse prognosis for nonmetastatic breast cancer patients. In this study, we prospectively assessed the association between different baseline characteristics (age, tumor characteristics, mode of treatment, etc) and outcomes among newly diagnosed nonmetastatic Lebanese breast cancer patients.
METHODS: We recruited a sample of 123 women newly diagnosed with nonmetastatic breast cancer presenting to American University of Beirut Medical Center. Immunohistochemical, molecular (vitamin D receptor, methylene tetrahydrofolate reductase polymorphisms), and genetic assays were performed. Patient characteristics were compared by age group (<40 and ≥40 years). A Cox regression analysis was performed to evaluate the variables affecting the disease-free survival (DFS). Outcome data were obtained, and DFS was estimated.
RESULTS: Among the 123 patients, 47 were 40 years of age or younger, and 76 were older than 40 years. Median follow-up duration was 58 months. Nine out of 47 patients <40 years (19.1%) experienced disease relapse in contrast to four out of 76 patients >40 years (5.2%). A wide immunohistochemical panel included Ki-67, cyclin B1, p53, platelet-derived growth factor receptor, and vascular endothelial growth factor receptor, and did not reveal any significant difference in these markers between the two age groups. Older patients had a larger percentage of Luminal A than younger patients. On multivariate analysis including age, stage, grade, and subtype, only age <40 and stage were significantly associated with shorter DFS with hazard ratios of 4 (
CONCLUSION: Being <40 years old was an independent risk factor for recurrence in this cohort of patients.
Keywords: disease-free survival; early; risk factor; subtypes; worse prognosis; young
Conflict of interest statement
Disclosure This work was supported by a grant to the American University of Beirut Medical Center from GlaxoSmithKline (GSK) (grant number 114579) for Ali Shamseddine. The authors report no other conf
References
- Breast Cancer Res Treat. 2013 Aug;140(3):463-73 - PubMed
- Eur J Clin Nutr. 2010 Apr;64(4):383-91 - PubMed
- J Clin Oncol. 2008 Jul 10;26(20):3324-30 - PubMed
- Clin Cancer Res. 2007 Apr 15;13(8):2329-34 - PubMed
- PLoS Med. 2010 May 25;7(5):e1000279 - PubMed
- World J Clin Oncol. 2014 Dec 10;5(5):1097-106 - PubMed
- J Am Coll Surg. 2000 May;190(5):523-9 - PubMed
- Ann Oncol. 2011 Aug;22(8):1736-47 - PubMed
- Transl Oncol. 2015 Aug;8(4):265-72 - PubMed
- J Clin Oncol. 2011 Oct 10;29(29):3885-91 - PubMed
- Hematol Oncol Stem Cell Ther. 2012;5(2):101-6 - PubMed
- J Natl Cancer Inst Monogr. 1994;(16):69-77 - PubMed
- Eur J Cancer. 2005 Jul;41(10):1446-52 - PubMed
- J Clin Oncol. 2016 Sep 20;34(27):3308-14 - PubMed
- Breast Cancer (Dove Med Press). 2016 Apr 05;8:53-8 - PubMed
- J Am Coll Surg. 2009 Mar;208(3):341-7 - PubMed
- J Clin Oncol. 2013 Jul 20;31(21):2692-8 - PubMed
- Semin Oncol. 2009 Jun;36(3):237-49 - PubMed
- Ann Surg Oncol. 2010 Jun;17(6):1471-4 - PubMed
- Metabolism. 2014 Jul;63(7):968-78 - PubMed
- BMC Cancer. 2006 Jul 20;6:194 - PubMed
- Ann Oncol. 2002 Feb;13(2):273-9 - PubMed
- Oncologist. 2015 Apr;20(4):357-64 - PubMed
- J Clin Oncol. 2010 Apr 1;28(10):1684-91 - PubMed
- J Thorac Dis. 2013 Jun;5 Suppl 1:S2-8 - PubMed
- Proc Natl Acad Sci U S A. 2001 Sep 11;98(19):10869-74 - PubMed
- Eur J Surg Oncol. 2016 Jul;42(7):919-25 - PubMed
- J BUON. 2015 Nov-Dec;20(6):1407-13 - PubMed
Publication Types