Up to 4% of breast cancer cases occur in women younger than 35 years. Studies have suggested an association between breast cancer at a young age, poorer outcome, and adverse clinical and pathologic characteristics. It is unclear whether age is an independent prognostic factor.
To characterize the prognostic significance of young age at diagnosis through comparison of disease characteristics of “less-young” (born between 1958–1962 and aged 37–44 years) and “very-young” (born after 1967 and aged ≤35 years) premenopausal patients.
Consecutive patients with breast cancer born after 1967 treated at Sheba Medical Centre between January, 1999 and October, 2002 were identified and their files reviewed. This cohort was identified as “very-young” and was compared with a group of “less-young” patients. The clinico-pathologic characteristics and survival data were compared.
Sixty-one very young and 94 less-young patients were identified. The mean age at diagnosis was 29.9 (range, 23–34 years) and 40.5 years (range, 37–44 years) for the very young and less young patients, respectively (P < 0.0001). Significantly more very young patients had metastatic disease at presentation (20% vs. 3%, respectively, P = 0.0007). The very young patients were more likely to have high grade, endocrine nonresponsive tumors than the less young patients. After controlling for stage and tumor grade, very-young age was not shown to be an independent risk factor for reduced survival.
Very young age among Israeli women with breast cancer is associated with higher stage at diagnosis, adverse pathologic characteristics and adverse outcome but is not an independent prognostic factor for survival.