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Poor outcome of hormone receptor-positive breast cancer at very young age is due to tamoxifen resistance: nationwide survival data in Korea--a report from the Korean Breast Cancer Society

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Authors
Ahn, Sei Hyun; Son, Byung Ho; Kim, Seok Won; Kim, Seung Il; Jeong, Joon; Ko, Seung-Sang; Han, Wonshik
Issue Date
2007-05-23
Publisher
American Society of Clinical Oncology
Citation
J Clin Oncol. 2007 Jun 10;25(17):2360-8. Epub 2007 May 21.
Keywords
AdultAge FactorsAntineoplastic Combined Chemotherapy Protocols/*therapeutic useBreast Neoplasms/drug therapy/metabolism/*mortality*Drug Resistance, NeoplasmFemaleHumansKoreaMiddle AgedPrognosisReceptors, Estrogen/*metabolismReceptors, Progesterone/*metabolismRegistriesSelective Estrogen Receptor Modulators/therapeutic useTamoxifen/*therapeutic use
Abstract
PURPOSE: Breast cancer in very young women (age < 35 years) is uncommon and poorly understood. We sought to evaluate the prognosis and treatment response of these patients compared with women ages 35 to 50 years. PATIENTS AND METHODS: We analyzed data from 9,885 breast cancer patients age < or = 50 years who were part of the Korean Breast Cancer Society registration program between 1992 and 2001. The overall survival (OS) and breast cancer-specific survival (BCSS) were compared between age groups. RESULTS: One thousand four hundred forty-four patients (14.6%) were younger than age 35 and 8,441 (85.4%) patients were between 35 and 50 years of age. Younger patients had significantly higher T-stage and higher lymph node positivity and lower hormone receptor expression than older patients. Younger patients had a greater probability of death than older patients, regardless of tumor size or lymph node status. The survival difference was significant for patients with positive or unknown hormone receptor status (P < .0001), but not for patients with negative hormone receptor status. In a multivariate analysis, the interaction term of young age and hormone receptor positivity was significant for OS and BCSS with a hazard ratio for OS of 2.13 (95% CI, 1.52 to 2.98). The significant survival benefit from adjuvant hormone therapy after chemotherapy observed in older patients (hazard ratio for OS, 0.61; 95% CI, 0.47 to 0.79; P = .001) could not be seen in younger patients (P > .05). CONCLUSION: Younger patients (age < 35) showed worse prognosis than older patients (age, 35 to 50 years) only in the hormone receptor-unknown or hormone receptor-positive subgroups. Adjuvant tamoxifen therapy might provide less survival benefit when added to chemotherapy in very young breast cancer patients.
ISSN
1527-7755 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17515570

http://hdl.handle.net/10371/11610
DOI
https://doi.org/10.3754

https://doi.org/10.1200/JCO.2006.10.3754
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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