Abstract P3-06-19: Large-scale retrospective analysis between 1980-2008 in 20 838 women with breast cancer - Results in young women (&lt; 40 years old)
Authors: Lerebours F , Stevens D , Jouanneau L , Guerard A , De La Lande B , Cherel P , Lasry S , Guinebretière J-M , Noguès C , Mouret-Fourme E 
Published: August 2014

Background: The risk for developing breast cancer before the age of 40 is less than 1% and is similar worldwide. Breast cancer in young women is different from that of older women in terms of clinical and pathological characteristics and prognosis. We reviewed the evolution of breast cancer in young women aged &lt; 40 years between 1980 and 2008 in the large database of the René Huguenin Hospital in France.

Patients and Methods: Women diagnosed with a first breast cancer were prospectively included in the institution database. The analysis population included all women treated and followed between 1980 and 2008 for new breast cancer. The data were grouped into three periods: 1980-1990 (systematic pre-screening), 1991-2003 (first pilot screening experiences) and 2004-2008 (generalized systematic screening) and per age group comparing women &lt;40 years and women ≥40 years.

Results: From 1980-2008, there were 20838 new breast cancers diagnosed, including 1431 (6.9%) in women &lt;40 years. The mean age at diagnosis in women &lt;40 years remained stable throughout the entire period at 35.2 years (min-max 19-39 years). Women &lt;40 years, compared to women ≥40 years, had a larger mean clinical tumor size at diagnosis (33.1 mm vs. 26.8 mm; p&lt;0.0001); lower proportion of stage I tumors (28.6% vs 43.9%; p&lt;0.0001); lower proportion of in situ cancers (7.6% vs 10.1%; p = 0.0034); more ductal invasive cancers (87% vs 78%; p&lt;0.0001); more histological grade 3 tumors (41% vs 25%; p&lt;0.0001); more HER2 overexpression (25.6% vs 10.5%; p&lt;0.0001), less hormone receptor-positive phenotype (68.7% vs 80.3%; p&lt;0.0001) and more triple negative phenotype (8.4% vs 5.3; p&lt;0.0001). Neo-adjuvant chemotherapy was more frequent in young women (21.2% vs 7.9%; p&lt;0.0001), as was adjuvant chemotherapy (47.4% vs 27.3%; p&lt;0.0001). The survival rates in women &lt;40 years were lower than in older women. Over the study period, among women &lt; 40 years analyzed for survival, 26.3% died from breast cancer and 2.4% died from another cause; in women ≥ 40 years, 14% died from breast cancer and 10.3% died from another cause. The overall survival rate, between 1980-1990, in patients &lt;40 years was 89.1% and 81.4% at 3-years and 5 years, respectively; while between 2004-2008, the overall survival rate was 96.6% and 91.4% at 3 and 5 years, respectively.

Conclusion: Results of the retrospective analysis of a very large cohort of women less than 40 years diagnosed with breast cancer show that woman &lt;40 years had a less favorable prognosis than older women. However, despite of not being included in screening programs, there was a substantial improvement in the prognosis for women &lt;40 years over the study period between 1980 and 2008, probably due to improved treatments.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-06-19.