Clinical profile and outcomes of young women with denovo-metastatic breast cancer: real-world data from a tertiary care centre in India.

IF 1.3 Q4 ONCOLOGY

ecancermedicalscience Pub Date : 2025-06-24 eCollection Date: 2025-01-01 DOI:10.3332/ecancer.2025.1932

Sushmita Rath, Mehak Trikha, Laboni Sarkar, Kunal Jobanputra, Akash Pawar, Revathy Krishnamurthy, Ayushi Sahay, Ayushi Sahay, Purvi Thakkar, Sneha Shah, Venkatesh Kapu, Anbarasan Sekar, Prabhat Bhargava, Seema Gulia, Rima Pathak, Tabassum Wadasadawala, Rajiv Sarin, Rajendra Badwe, Sudeep Gupta, Jyoti Bajpai

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Abstract

Background: Denovo metastatic young breast cancer (dnmYBC), defined as age <40 years, is a challenging entity, with a significant burden and sparse data from low and middle-income countries.

Method: We analysed the prospectively collected data of dnmYBC women from 2015 to 2016.

Results: There were 188 dnmYBC with a median age of 35.5 years. Of these, hormone receptor positive (HR+) were 72 (38.3) %, triple-negatives (TNBC) were 45 (23.9) %, Human Epidermal Growth Factor Positive (HER2+) were 42 (22.4) % and triple positives were 29 (15.4) %. TNBC women predominantly had visceral 40 (88.9%) metastasis, HR+ had nodal 51 (70.8%) and skeletal 10 (13.8%), while HER2+ women had higher brain metastasis (BM) 16 (38.1%).At a median follow-up of 39.8 [Interquartile range (IQR): 24-55.5] months, the median event-free survival (EFS) was 9.3 (95% CI; 8.1-10.4) months for the entire cohort and 1-year, 2-year and 3-year predicted EFS were 47.8%, 13.4% and 3%, respectively. The median EFS was superior in HR+ women.[15.7 months, hormone receptor (HR)-0.53;95% CI-9.8-21.7; p-0.013] versus (11.4 months, 95 %CI-5.9-16.8) in TNBC versus (7.7 months, 95% CI-6.0-9.5) in HER-2 + women and without BM at baseline [9.3 versus 3.0 months (with BM), HR-5.65; CI-1.72-17.9; p-0.001]. Median EFS was superior in the treatment-naïve (155, 82.4%) versus prior-treated (33, 17.5%) women, 35.5 (95% CI:12.24-58.72) versus 12.4 (95% CI:11.45-13.51) months; p-0.000]. The HER2+ women who received targeted therapy in the first line had a significantly superior median EFS of 13.0 versus 7.7 months (HR -0.465:CI 0.22-0.57: p-0.038).

Conclusion: Denovo mYBC is associated with an aggressive course, poor prognosticators include HR negative disease, brain metastasis, inadvertent prior treatment and inadequate access to targeted therapies. Early diagnosis, prompt treatment and expanding accessibility are warranted to improve care.

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年轻女性原发性转移性乳腺癌的临床概况和结果：来自印度三级保健中心的真实数据。

背景：Denovo转移性年轻乳腺癌（dnmYBC），定义为年龄方法：我们对2015年至2016年前瞻性收集的dnmYBC女性数据进行分析。结果：dnmYBC患者188例，中位年龄35.5岁。其中激素受体阳性（HR+） 72(38.3) %，三阴性（TNBC） 45(23.9) %，人表皮生长因子阳性（HER2+） 42(22.4) %，三阳性29(15.4)%。TNBC女性主要有内脏转移40例（88.9%），HR+有淋巴结转移51例（70.8%）和骨骼转移10例（13.8%），而HER2+女性有更高的脑转移16例（38.1%）。中位随访39.8个月[四分位数间距（IQR）： 24-55.5]，中位无事件生存期（EFS）为9.3 (95% CI；整个队列8.1-10.4个月，1年、2年和3年预测EFS分别为47.8%、13.4%和3%。HR+女性的中位EFS更优。[15.7个月，激素受体(HR)-0.53;95% CI-9.8-21.7；p-0.013] TNBC患者（11.4个月，95% CI-5.9-16.8）与基线时HER-2 +且无基底膜的女性（7.7个月，95% CI-6.0-9.5）相比[9.3个月，3.0个月（有基底膜），HR-5.65；ci - 1.72 - 17.9;p - 0.001]。中位EFS在treatment-naïve（155, 82.4%）妇女中优于先前治疗的（33,17.5%）妇女，35.5 （95% CI:12.24-58.72）对12.4 （95% CI:11.45-13.51）个月；p - 0.000]。在一线接受靶向治疗的HER2阳性妇女的中位EFS显著优于7.7个月（HR -0.465:CI 0.22-0.57: p-0.038）。结论：Denovo mYBC与侵袭性病程相关，不良预后因素包括HR阴性疾病、脑转移、先前治疗疏忽和靶向治疗不足。早期诊断、及时治疗和扩大可及性是改善护理的必要条件。

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