Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: the Saudi Arabia experience.
Being 40 or younger is an independent risk factor for relapse in operable breast cancer patients: the Saudi Arabia experience.
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DOI：
10.1186/1471-2407-7-222
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发表时间：
2007-12-05
期刊：
影响因子：
3.8
通讯作者：
Al-Tweigeri T
中科院分区：
文献类型：
--
作者：
Elkum N;Dermime S;Ajarim D;Al-Zahrani A;Alsayed A;Tulbah A;Al Malik O;Alshabanah M;Ezzat A;Al-Tweigeri T
沙特年轻女性的乳腺癌是一个关键问题。根据沙特国家癌症登记处2002年的年度报告，40岁以前患上的乳腺癌占所有女性乳腺癌的26.4%，而美国为6.5%。年轻患者的乳腺癌通常与预后较差有关，但中东人群的已发表数据很少。共867例乳腺癌患者在费萨尔国王专科医院和研究中心（KFSH&RC）1986年和2002年之间进行了审查。患者分为两个年龄组：≤ 40岁和40岁以上。比较青年组和老年组的临床病理特征和治疗结果。就诊时的中位年龄为45岁。共有288例（33.2%）患者年龄≤ 40岁。40岁患者中69%和40岁以上患者中78.2%的激素受体阳性（p = 0.009）。与老年患者相比，年轻患者中III级肿瘤的发生率显著更高（p = 0.0006）。分期、肿瘤大小、淋巴管/血管浸润、淋巴结数量和腋窝淋巴结状态在两个年龄组之间没有显著差异。在所有时间段，年轻患者的复发概率更高（p = 0.035）。年轻对腋窝淋巴结阳性患者的生存率有负面影响（p = 0.030），但对淋巴结阴性患者的生存率没有影响（p = 0.695）。分期、肿瘤大小、淋巴结状态和激素受体对生存率有负面影响。87.9%的年轻患者和65.6%的老年患者接受了辅助化疗（p < 0.0001）。在激素治疗方面，他莫昔芬治疗的患者比例在年轻组中显著较低（p < 0.0001）。两组放射治疗差异无统计学意义。年轻（≤ 40岁）是可手术沙特乳腺癌患者复发的独立风险因素。年轻乳腺癌患者的基本生物学需要阐明。
Breast cancer in young Saudi women is a crucial problem. According to the 2002 annual report of Saudi National Cancer Registry, breast cancers that developed before the age of 40 comprise 26.4% of all female breast cancers comparing to 6.5% in the USA. Breast cancer in young patients is often associated with a poorer prognosis, but there has been a scarcity of published data in the Middle East population. Total of 867 breast cancer patients seen at King Faisal Specialist Hospital & Research Centre (KFSH&RC) between 1986 and 2002 were reviewed. Patients were divided in two age groups: ≤ 40 years and above 40 years. The clinicopathological characteristics and treatment outcomes were compared between younger and older age groups. Median age at presentation was 45 years. A total of 288 (33.2%) patients were aged ≤ 40 years. Hormone receptors were positive in 69% of patients 40 and 78.2% of patients above 40 (p = 0.009). There was a significantly higher incidence of grade III tumor in younger patients compared to older patients (p = 0.0006). Stage, tumor size, lymphatic/vascular invasion, number of nodes and axillary lymph node status, did not differ significantly between the two age groups. Younger patients had a greater probability of recurrence at all time periods (p = 0.035). Young age had a negative impact on survival of patients with positive axillary lymph nodes (p = 0.030) but not on survival of patients with negative lymph nodes (p = 0.695). Stage, tumor size, nodal status and hormonal receptors had negative impact on survival. Adjuvant chemotherapy was administered to 87.9% of younger and 65.6% of older patients (p < 0.0001). In terms of hormone therapy, the proportion of tamoxifen treated patients was significantly lower in young age group (p < 0.0001). No significant difference in radiation therapy between the two groups. Young age (≤ 40) is an independent risk factor for relapse in operable Saudi breast cancer patients. The fundamental biology of young age breast cancer patients needs to be elucidated.