Jonathan Pruessmann1, Telja Pursche2,3, Friederike Hammersen1, Alexander Katalinic1,4, Dorothea Fischer5, Annika Waldmann1,6. 1. Institute for Social Medicine and Epidemiology, Lübeck University, Lübeck, Germany. 2. Department of Gynaecology and Obstetrics, University Hospital Schleswig-Holstein, Lübeck, Germany. 3. Department of Gynaecology and Obstetrics, Hospital Düren gem. GmbH, Düren, Germany. 4. Cancer Registry Schleswig-Holstein, Lübeck, Germany. 5. Department of Gynaecology and Obstetrics, Hospital Ernst von Bergmann, Potsdam, Germany. 6. Hamburg Cancer Registry, Hamburg, Germany.
Abstract
BACKGROUND: Breast cancer in young women is associated with unfavourable tumour biology and is the main cause of death in this group. Conditional survival analysis estimates survival rates under the pre-condition of already having survived a certain time. OBJECTIVES: To describe conditional disease-free and overall survival of female breast cancer patients according to clinical subtypes and age. METHODS: This study analyses information from 1,858 breast cancer patients aged between 21 and 54 years, who were taking part in a post-therapeutic rehab programme (time between diagnosis and rehab start: maximum 24, median 11 months). Mean follow-up time was 3.6 years. We describe biological, clinical and pathological features in regard to different age groups (<40 and ≥40 years) and report conditional 5-year survival rates for overall and disease-free survival, and Cox proportional hazard models. RESULTS: Very young and young patients differed in regard to hormone receptor negativity, tumour grade, lymphovascular invasion, and molecular subtypes. Young women bore triple-negative and HER2-like disease more frequently. Conditional 5-year overall survival did not differ substantially between women <40 and 40-54 years of age (95 vs. 96%). It was highest for women with cancer of the luminal A subtype (98%) and lowest for the triple-negative subtype (91%). Lymphangiosis was a significant predictor of death. Results for disease-free survival were comparable. CONCLUSIONS: Conditional 5-year overall survival after non-metastatic breast cancer was as high as 95.5%, and disease-free survival was 85.2%. When controlling for time between diagnosis and rehab start, molecular subtypes influenced overall and disease-free survival prospects. When additionally controlling for clinical characteristics, this effect only remained stable for disease-free survival.
BACKGROUND: Breast cancer in young women is associated with unfavourable tumour biology and is the main cause of death in this group. Conditional survival analysis estimates survival rates under the pre-condition of already having survived a certain time. OBJECTIVES: To describe conditional disease-free and overall survival of female breast cancer patients according to clinical subtypes and age. METHODS: This study analyses information from 1,858 breast cancer patients aged between 21 and 54 years, who were taking part in a post-therapeutic rehab programme (time between diagnosis and rehab start: maximum 24, median 11 months). Mean follow-up time was 3.6 years. We describe biological, clinical and pathological features in regard to different age groups (<40 and ≥40 years) and report conditional 5-year survival rates for overall and disease-free survival, and Cox proportional hazard models. RESULTS: Very young and young patients differed in regard to hormone receptor negativity, tumour grade, lymphovascular invasion, and molecular subtypes. Young women bore triple-negative and HER2-like disease more frequently. Conditional 5-year overall survival did not differ substantially between women <40 and 40-54 years of age (95 vs. 96%). It was highest for women with cancer of the luminal A subtype (98%) and lowest for the triple-negative subtype (91%). Lymphangiosis was a significant predictor of death. Results for disease-free survival were comparable. CONCLUSIONS: Conditional 5-year overall survival after non-metastatic breast cancer was as high as 95.5%, and disease-free survival was 85.2%. When controlling for time between diagnosis and rehab start, molecular subtypes influenced overall and disease-free survival prospects. When additionally controlling for clinical characteristics, this effect only remained stable for disease-free survival.
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