The Prognostic Impact of Age in Different Molecular Subtypes of Breast Cancer: a Population-based Study

Overview

Journal PeerJ

Specialties Biology
Environmental Health
General Medicine

Date 2019 Jul 17

PMID 31309004

Citations 13

Authors

Dongjun Dai

Yiming Zhong

Zhuo Wang

Neelum Aziz Yousafzai

Hongchuan Jin

Xian Wang

Affiliations

Soon will be listed here.

Abstract

Background: The aim of current study was to use competing risk model to calculate the potential differences that age played in the prognosis of different breast cancer subtypes.

Methods: The cohort was selected from Surveillance, Epidemiology, and End Results (SEER) program. The cumulative incidences of death (CID) was assessed for breast cancer caused deaths and other causes of mortality. The multivariate Cox proportional hazards regression model and the multivariate subdistribution hazard (SH) model were used to evaluate the prognostic value of age in different breast cancer subtypes.

Results: We involved 33,968 breast cancer patients into our cohort. We found older patients had worse overall survival (OS) than young patients in hormone receptor positive and human epidermal growth factor receptor 2 positive breast cancer (HR+/HER2+) (≥40 vs. <40, HR = 2.07, 95% CI [1.28-3.35], < 0.05). However, when we used competing risk model, we found young age was an independent risk factor only for triple negative breast cancer (TNBC) (≥40 vs. <40, HR = 0.71, 95% CI [0.56-0.89], < 0.05). No association was found in other groups.

Conclusion: Our research was currently the largest sample size study and the first competing risk model-based study on the prognostic association between age and different breast cancer subtypes. We found <40 years patients had worse breast cancer specific survival (BCSS) than older patients in the TNBC subtype.

Citing Articles

Cell Populations in Human Breast Cancers are Molecularly and Biologically Distinct with Age.

Parsons A, Colon E, Spasic M, Kurt B, Swarbrick A, Freedman R Res Sq. 2024; .

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Advances in 3D Culture Models to Study Exosomes in Triple-Negative Breast Cancer.

Yousafzai N, El Khalki L, Wang W, Szpendyk J, Sossey-Alaoui K Cancers (Basel). 2024; 16(5).

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A Retrospective Exploratory Analysis for Serum Extracellular Vesicles Reveals APRIL (TNFSF13), CXCL13, and VEGF-A as Prognostic Biomarkers for Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer.

Jung H, Kim J, Cho E, Lee J, Kim S, Nam S Int J Mol Sci. 2023; 24(21).

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Age has a U-shaped relationship with breast cancer outcomes in women: a cohort study.

Xie Y, Deng Y, Wei S, Huang Z, Li L, Huang K Front Oncol. 2023; 13:1265304.

PMID: 37860197 PMC: 10583555. DOI: 10.3389/fonc.2023.1265304.

Molecular subtypes as a prognostic breast cancer factor in women users of the São Paulo public health system, Brazil.

Peres S, Arantes P, Fagundes M, AbSaber A, Gimenes D, Curado M Rev Bras Epidemiol. 2023; 26:e230028.

PMID: 37255208 PMC: 10229073. DOI: 10.1590/1980-549720230028.

References

Yasui Y, Potter J . The shape of age-incidence curves of female breast cancer by hormone-receptor status. Cancer Causes Control. 1999; 10(5):431-7. DOI: 10.1023/a:1008970121595. View

Shoker B, Jarvis C, Clarke R, Anderson E, Hewlett J, Davies M . Estrogen receptor-positive proliferating cells in the normal and precancerous breast. Am J Pathol. 1999; 155(6):1811-5. PMC: 1866935. DOI: 10.1016/S0002-9440(10)65498-3. View

Perou C, Sorlie T, Eisen M, van de Rijn M, Jeffrey S, Rees C . Molecular portraits of human breast tumours. Nature. 2000; 406(6797):747-52. DOI: 10.1038/35021093. View

Sorlie T, Perou C, Tibshirani R, Aas T, Geisler S, Johnsen H . Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci U S A. 2001; 98(19):10869-74. PMC: 58566. DOI: 10.1073/pnas.191367098. View

Tarone R, Chu K . The greater impact of menopause on ER- than ER+ breast cancer incidence: a possible explanation (United States). Cancer Causes Control. 2002; 13(1):7-14. DOI: 10.1023/a:1013960609008. View

Satagopan J, Ben-Porat L, Berwick M, Robson M, Kutler D, Auerbach A . A note on competing risks in survival data analysis. Br J Cancer. 2004; 91(7):1229-35. PMC: 2410013. DOI: 10.1038/sj.bjc.6602102. View

Albrektsen G, Heuch I, Hansen S, Kvale G . Breast cancer risk by age at birth, time since birth and time intervals between births: exploring interaction effects. Br J Cancer. 2004; 92(1):167-75. PMC: 2361726. DOI: 10.1038/sj.bjc.6602302. View

Britt K, Ashworth A, Smalley M . Pregnancy and the risk of breast cancer. Endocr Relat Cancer. 2007; 14(4):907-33. DOI: 10.1677/ERC-07-0137. View

Anders C, Hsu D, Broadwater G, Acharya C, Foekens J, Zhang Y . Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008; 26(20):3324-30. DOI: 10.1200/JCO.2007.14.2471. View

10.

Gnerlich J, Deshpande A, Jeffe D, Sweet A, White N, Margenthaler J . Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. J Am Coll Surg. 2009; 208(3):341-7. PMC: 3262236. DOI: 10.1016/j.jamcollsurg.2008.12.001. View

11.

Bharat A, Aft R, Gao F, Margenthaler J . Patient and tumor characteristics associated with increased mortality in young women (< or =40 years) with breast cancer. J Surg Oncol. 2009; 100(3):248-51. DOI: 10.1002/jso.21268. View

12.

Anderson S, Wapnir I, Dignam J, Fisher B, Mamounas E, Jeong J . Prognosis after ipsilateral breast tumor recurrence and locoregional recurrences in patients treated by breast-conserving therapy in five National Surgical Adjuvant Breast and Bowel Project protocols of node-negative breast cancer. J Clin Oncol. 2009; 27(15):2466-73. PMC: 2684852. DOI: 10.1200/JCO.2008.19.8424. View

13.

Anders C, Johnson R, Litton J, Phillips M, Bleyer A . Breast cancer before age 40 years. Semin Oncol. 2009; 36(3):237-49. PMC: 2894028. DOI: 10.1053/j.seminoncol.2009.03.001. View

14.

Blows F, Driver K, Schmidt M, Broeks A, van Leeuwen F, Wesseling J . Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med. 2010; 7(5):e1000279. PMC: 2876119. DOI: 10.1371/journal.pmed.1000279. View

15.

Perou C, Borresen-Dale A . Systems biology and genomics of breast cancer. Cold Spring Harb Perspect Biol. 2010; 3(2). PMC: 3039533. DOI: 10.1101/cshperspect.a003293. View

16.

Anders C, Fan C, Parker J, Carey L, Blackwell K, Klauber-DeMore N . Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes?. J Clin Oncol. 2010; 29(1):e18-20. PMC: 3055864. DOI: 10.1200/JCO.2010.28.9199. View

17.

Beadle B, Woodward W, Buchholz T . The impact of age on outcome in early-stage breast cancer. Semin Radiat Oncol. 2010; 21(1):26-34. PMC: 3041510. DOI: 10.1016/j.semradonc.2010.09.001. View

18.

Peshkin B, Alabek M, Isaacs C . BRCA1/2 mutations and triple negative breast cancers. Breast Dis. 2011; 32(1-2):25-33. PMC: 3870050. DOI: 10.3233/BD-2010-0306. View

19.

Reis-Filho J, Pusztai L . Gene expression profiling in breast cancer: classification, prognostication, and prediction. Lancet. 2011; 378(9805):1812-23. DOI: 10.1016/S0140-6736(11)61539-0. View

20.

Tran B, Bedard P . Luminal-B breast cancer and novel therapeutic targets. Breast Cancer Res. 2012; 13(6):221. PMC: 3326541. DOI: 10.1186/bcr2904. View