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Treatment approaches key to outcomes among young women with breast cancer
Young women with breast cancer appeared to have more aggressive disease than women diagnosed at an older age but similar overall outcomes when the recommended treatment is given, according to results of two retrospective studies presented at European Society for Medical Oncology Breast Cancer Congress.
“Women [younger than age] 40 years tend to be diagnosed with more aggressive breast cancer types — for example, their tumors are more likely to be triple-negative and HER2-positive,” Matteo Lambertini, MD, medical oncologist at San Martino Hospital, adjunct professor at University of Genoa in Italy, and ESMO spokesman, said in a press release. “Despite this, survival and local recurrence rates are similar to those of the general population of [patients with breast cancer] provided they receive appropriate treatment.”
The first study — conducted by Simona Cima, MD, oncologist at the Oncology Institute of Southern Switzerland, and colleagues — analyzed rates of recurrence in young patients with breast cancer treated at Ticino Breast Unit between 2010 and 2017.
Cima and colleagues evaluated records of 381 women aged 50 years or younger with stage I to stage III invasive breast cancer. The researchers assessed tumor biology, type of surgery and neoadjuvant/adjuvant therapy, site of disease recurrence, time of recurrence and OS.
Median age at diagnosis was 45 years (range, 23-50).
Median follow-up was 45.6 months (range, 1-105).
Researchers lost 22 patients to follow-up.
Results showed 29 patients (7.6%) experienced tumor relapse, including nine who died.
Another 14 patients developed locoregional recurrence, six patients developed distant metastases and nine patients had a combination of locoregional recurrence and distant metastases.
“Locoregional recurrence and distant metastases rates of our population do not differ from those published in literature,” Cima and colleagues wrote.
The most common site of locoregional failure was the ipsilateral breast (n = 11). Two patients developed another tumor in the contralateral breast.
Median interval to recurrence was 31 months (range, 3-87).
Risk for locoregional recurrence was 4.7% at 3 years and 9.5% at 5 years.
Researchers observed 3-year DFS of 94.3%, 5-year DFS of 91.2%, and 5-year OS of 93.3%.
“Most recurrences in these patients were local rather than metastatic,” Cima said in a press release. “Our study is ongoing, and the next step is to identify predictors for local recurrence. For example, we will examine the likelihood of local recurrence according to HER2 and triple-negative status.”
The second study — conducted by Ines F. Eiriz, MD, oncologist in the clinical unit of oncology at Hospital Prof. Doutor Fernando Fonseca in Portugal, and colleagues — assessed breast cancer incidence, tumor stage, biology, treatment and survival among 172 women aged younger than 35 years (median age, 31 years). Most of the women (91%) had ductal invasive carcinoma.
Researchers observed higher percentages of more aggressive tumor subtypes, which included luminal B HER2 negative (47%), luminal B HER2 positive (20%), triple negative (20%), HER2 positive, hormone receptor negative (8%) and luminal A (4%).
Nearly half of patients (48%) were diagnosed with early breast cancer, 45% had locally advanced disease and 6% had de novo metastatic cancer.
Thirty-nine percent of patients received neoadjuvant chemotherapy, and 12% achieved pathological complete response.
Most patients (83%) received adjuvant systemic chemotherapy or endocrine therapy (18% endocrine therapy exclusively).
After median follow-up was 53.5 months, 85% of the women remained alive.
Results showed 37 patients developed metastatic disease.
Median survival among patients with metastatic disease was 16.5 months. Three patients experienced local recurrence, with a median time of 27 months.
“It’s not true that being diagnosed with breast cancer at a young age means poorer survival or higher chances of the cancer coming back, and these studies confirm that,” Lambertini said in the release. “Proper guideline-recommended treatments should be given to all [patients with] breast cancer, regardless of their age. Special attention should be paid in these women on the potential side effects of anticancer therapies, including the risk [for] infertility.” – by John DeRosier
References:
Cima S, et al. Abstract 102P_PR. Presented at: ESMO Breast Cancer Congress; May 2-4, 2019; Berlin.
Eiriz IF, et al. Abstract 101P_PR. Presented at: ESMO Breast Cancer Congress; May 2-4, 2019; Berlin.
Disclosures: The authors report no relevant financial disclosures.