Breast cancer (BC) in very young patients (≤ 35 years) (BCVY) is an uncommon disease and when it occurs it usually has aggressive biological characteristics. The objective of this study was to evaluate the relevance of clinical-pathologic factors and prognosis in BCVY cancer patients versus a cohort of older counterparts.
258 patients (Group I) diagnosed of BCVY retrospectively analyzed in our hospital between 1998 to 2014 and relate to 101 patients over 45 years with BC (Group II). All data related to clinical, pathological features were obtained from medical records, and we used chi-squared to compare them. In addition, we correlate any clinic-pathological factors with the expression of miRNAs (previously published by our group Peña-chilet et al. 2014).
T stage, histological grade, c-erbB2 expression and ER status did not differ significantly between the two age groups. BVCY patients had a greater probability of recurrence and death at all periods (45% have presented a relapse of BC compared to 21% of group II). The BCVY group showed worse prognosis among lymph node-positive patients (p= 0.02). The status of lymph nodes post-surgery seems to be the only factor related to BCVY patients. In group I, we objectify also a statistically significant relationship between axillary involvement, IHQ HER2 positive subtype and disease relapse (p = 0.03). We also observed a lower time between diagnosis and first relapse with a more likelihood to die from the disease to BCVY (p = 0.002). Finally, from our panel of deregulated miRNAs (miR-30c, miR-125a, miR-17, miR-92b, miR-139 and miR-663) we are able to associate repressed miR-30 with more aggressive BCVY with lower overall survival and with axillary metastases.
Patient age and axillary lymph nodes post-surgery are the independent and significant predictors of distant disease-free survival, local recurrence-free survival, and overall survival. HER2 subtype and repressed miR-30 relates to poor prognosis in lymph node-positive young patients. The risk factor grouping provides a useful index to evaluate the risk of BCVY to identify subgroups of patients with better prognosis.
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All authors have declared no conflicts of interest.