Survival outcomes of young-age female patients with early breast cancer: an international multicenter cohort study

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2024-10-15 DOI:10.1016/j.esmoop.2024.103732

{"title":"Survival outcomes of young-age female patients with early breast cancer: an international multicenter cohort study","authors":"","doi":"10.1016/j.esmoop.2024.103732","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The incidence of breast cancer among young Asian women is increasing, yet they remain underrepresented in global data. We analyzed the epidemiology and outcomes of Asian patients with breast cancer <40 years old across different subtypes to identify their clinical unmet needs.</div></div><div><h3>Patients and methods</h3><div>Female patients aged ≥20 years diagnosed with early breast cancer were analyzed from the prospective cohort of the Asian Breast Cancer Cooperative Group (ABCCG). For comparison, data from the Surveillance, Epidemiology, and End Results Program (SEER) cancer registry were used. Patients were categorized into three age groups: young (<40 years), alleged premenopausal mid-age (40-49 years), and alleged postmenopausal (aged ≥50 years). Multivariable Cox proportional hazards models for survival were adjusted for subtypes, histologic grade, T stage, nodal status, and study centers.</div></div><div><h3>Results</h3><div>A total of 45 021 patients with breast cancer from Asian study centers, 496 332 SEER-White patients, and 18 279 SEER-Asian patients were included in the analysis. The median age at diagnosis was younger in the Asian cohort (51 years) compared with SEER-Whites (62 years) and SEER-Asians (58 years; <em>P</em> < 0.0001). In the young-age group, hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2−) breast cancer was more prevalent among Asians and SEER-Asians compared with SEER-Whites (61.2% and 59.8% versus 54.7%). In the Asian population, young patients with HR+/HER2− breast cancer exhibited significantly inferior overall survival than the mid-age group (6-year overall survival 94.4% versus 96.6%; mid-age to young-age group hazard ratio 0.62; <em>P</em> < 0.001). Similarly, young patients in SEER-Whites showed an earlier decline in survival compared with the mid-age group (89.1% versus 94.0%; <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>ABCCG-Asian patients with breast cancer <40 years old with HR+/HER2− subtypes were more likely to have worse survival outcomes than their mid-age counterparts. Our study highlights the poorer prognosis of young patients and underscores the need for a tailored therapeutic approach, such as ovarian function suppression, particularly considering ethnic factors.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":null,"pages":null},"PeriodicalIF":7.1000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESMO Open","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2059702924015023","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The incidence of breast cancer among young Asian women is increasing, yet they remain underrepresented in global data. We analyzed the epidemiology and outcomes of Asian patients with breast cancer <40 years old across different subtypes to identify their clinical unmet needs.

Patients and methods

Female patients aged ≥20 years diagnosed with early breast cancer were analyzed from the prospective cohort of the Asian Breast Cancer Cooperative Group (ABCCG). For comparison, data from the Surveillance, Epidemiology, and End Results Program (SEER) cancer registry were used. Patients were categorized into three age groups: young (<40 years), alleged premenopausal mid-age (40-49 years), and alleged postmenopausal (aged ≥50 years). Multivariable Cox proportional hazards models for survival were adjusted for subtypes, histologic grade, T stage, nodal status, and study centers.

Results

A total of 45 021 patients with breast cancer from Asian study centers, 496 332 SEER-White patients, and 18 279 SEER-Asian patients were included in the analysis. The median age at diagnosis was younger in the Asian cohort (51 years) compared with SEER-Whites (62 years) and SEER-Asians (58 years; P < 0.0001). In the young-age group, hormone receptor-positive/human epidermal growth factor receptor 2 negative (HR+/HER2−) breast cancer was more prevalent among Asians and SEER-Asians compared with SEER-Whites (61.2% and 59.8% versus 54.7%). In the Asian population, young patients with HR+/HER2− breast cancer exhibited significantly inferior overall survival than the mid-age group (6-year overall survival 94.4% versus 96.6%; mid-age to young-age group hazard ratio 0.62; P < 0.001). Similarly, young patients in SEER-Whites showed an earlier decline in survival compared with the mid-age group (89.1% versus 94.0%; P < 0.001).

Conclusion

ABCCG-Asian patients with breast cancer <40 years old with HR+/HER2− subtypes were more likely to have worse survival outcomes than their mid-age counterparts. Our study highlights the poorer prognosis of young patients and underscores the need for a tailored therapeutic approach, such as ovarian function suppression, particularly considering ethnic factors.

查看原文本刊更多论文

早期乳腺癌年轻女性患者的生存结果：一项国际多中心队列研究

背景亚洲年轻女性的乳腺癌发病率正在上升，但她们在全球数据中的代表性仍然不足。我们分析了不同亚型的 40 岁亚洲乳腺癌患者的流行病学和预后，以确定她们尚未满足的临床需求。患者和方法分析了亚洲乳腺癌合作组（ABCCG）前瞻性队列中被诊断为早期乳腺癌的年龄≥20 岁的女性患者。为了进行比较，还使用了监测、流行病学和最终结果计划（SEER）癌症登记处的数据。患者被分为三个年龄组：年轻组（40 岁）、绝经前中年组（40-49 岁）和绝经后组（年龄≥50 岁）。根据亚型、组织学分级、T分期、结节状态和研究中心调整了生存率的多变量Cox比例危险模型。结果共有45 021名来自亚洲研究中心的乳腺癌患者、496 332名SEER-白人患者和18 279名SEER-亚洲患者被纳入分析。与SEER-白人（62岁）和SEER-亚洲人（58岁；P < 0.0001）相比，亚洲人组群的中位诊断年龄更小（51岁）。在年轻组中，激素受体阳性/人表皮生长因子受体 2 阴性（HR+/HER2-）乳腺癌在亚洲人和 SEER-亚洲人中的发病率高于 SEER-白种人（61.2% 和 59.8% 对 54.7%）。在亚洲人群中，HR+/HER2-乳腺癌年轻患者的总生存率明显低于中年组（6 年总生存率为 94.4% 对 96.6%；中年组与年轻组危险比为 0.62；P <0.001）。同样，与中年组相比，SEER-Whites 中的年轻患者生存率下降得更早（89.1% 对 94.0%；P <；0.001）。结论ABCCG-亚洲 40 岁、HR+/HER2- 亚型乳腺癌患者的生存结果比中年患者更差。我们的研究强调了年轻患者的预后较差，并强调了采取针对性治疗方法的必要性，如卵巢功能抑制，尤其要考虑种族因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.