폐경기 이전 여성 유방암 환자에서 나이에 따른 특성과 예후의 차이 = Clinical significance of age for premenopausal women with primary breast cancer

다국어 초록 (Multilingual Abstract)

Purpose: Breast carcinoma in young patients has been reported to present with more aggressive biologic characteristics and to behave poorer compared
with the disease in older patients. However, the association between the age and the prognosis in premenopausal patients has rarely been reported on.
This study aimed to reveal the clinicopathologic characteristics and prognostic significance of young age (age 35) for the breast cancer of premenopausal women. Methods: We retrospectively analyzed 1033 premenopausal women with breast cancer who underwent surgery in our institution between 1985 and 2003. A total of 180 patients were aged >35 years
(the younger premenopausal group) and 853 patients were aged >35 years (the older premenopausal group). The clinicopathologic characteristics
and treatment outcomes were compared between the younger and older groups. Results: Compared to the older premenopausal group, the younger group showed earlier menarche (15.2 19 years old versus 16.0 1.7 years old, respectively, p<0.001), larger tumor (3.7 2.1cm versus 3.2 2.0cm, respectively, p=0.002), more metastatic axillary lymph nodes (3.8 7.0 versus 2.4 5.7,
respectively, p=0.001), more advanced TNM stage (p=0.015), a lower PR positive rate (47.7% versus 59.9%, respectively, p=0.011), and a higher P53 positive rate (71.7% versus 54.9%, respectively, p=0.034). The recurrence rate for the younger group was 26% as compared with 14.4% for the older group. The overall 5-year and 10-year survival rates of younger group were 79.3% and 68.5%, respectively and these of older group were 91.1% and 84.3%, respectively. Conclusion: In premenopausal women with breast cancer, patients with an age 35 years have a greater chance of having an endocrine non-responsive tumor, and they are more likely present with larger tumor, more metastatic axillary lymph nodes and a more advanced TMN stage. These results show that younger premenopausal patients have a worse prognosis than older premenopausal patients.