Abstract 220P
Background
Breast cancer (BC) is the most common cause of cancer-related death in young women, but stages I to III are highly curable regardless of age. Classically HER2-positive disease has been considered a poor prognosis but few studies have evaluated the impact of anti-HER2 treatments. Knowing the risk of recurrence and time to recurrence can determine follow-up and time to follow, key issues for a population with a potentially long survival.
Methods
A retrospective analysis of YBCP (≤45 years) treated at HUPHM, diagnosed with early infiltrating breast cancer between 2009-2019 and with a mínimum follow up of 24 months was made. We analyzed distant disease-free survival (DDFS) and time to distant relapse adjusted by subtypes and stage in patients with stages I to III. The Kaplan-Meier method, Kruskall-Wallis technique and Mann Whitney test were carried out to analyze DDFS and the interaction between prognostic variables.
Results
519 patients were included, triple negative (TN) 12.3%; HHRR+/HER2- 71.1%; HHRR+/HER2+ 12.1%; HHRR-/HER2+ 4.5%. With a median follow-up of 70.4 months, 16% of relapses were observed. A significant association between histological subtype and DDFS was presented P=0.0024, median DDFS or death of 22.7, 61.3, 60.7, y 68.6 months for TN, HHRR+/HER2-, HHRR+/HER2+ and HHRR-/HER2+ respectively. We detected a significantly shorter time to recurrence or death for TN breast cancer, P=0.003. No differences were founded between HHRR-positive disease and HHRR-negative/HER2-positive in time to distant relapse.
Conclusions
Early breast carcinoma is highly curable also in YBCP but follow up is needed due to the risk of recurrence. Triple-positive disease seems to be the best prognostic subtype. The type of follow up and its duration are not universally established, and can be adapted to the risk of each patient. We observed an association between tumor subtype and the time of distant recurrence, with the shorter systemic recurrence time for TN patients. For the rest of subtypes, we did not observe any difference between them. Our real-life data also reflect a prolonged DDFS for patients with HHRR+ or HER2+, close to 5 years even for stage III, changing the classical prognosis described for HER2-positive disease, suggesting the need for prolonged follow up.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.