ESMO Breast Cancer 2019: Outcomes in Younger Patients With Breast Cancer
Breast cancer in young women is characterized by more aggressive biologic features as compared to older patients, but outcomes are good when guideline-recommended treatments are given. European Society for Medical Oncology (ESMO) spokesperson Matteo Lambertini, MD, PhD, of IRCCS Policlinico San Martino Hospital–University of Genoa, Italy, concluded this when commenting on the results of two studies to be presented during the ESMO Breast Cancer Congress 2019.
Young age is not a reason to give more intensive treatment, highlighted Dr. Lambertini. “Women under 40 years of age tend to be diagnosed with more aggressive breast cancer types—for example, their tumors are more likely to be triple-negative and HER2-positive. Despite this, survival and local recurrence rates are similar to those of the general population of [patients with] breast cancer, provided they receive appropriate treatment.”
Disease Aggressiveness
The aggressiveness of tumors in younger women will be illustrated in a study from Portugal in 207 patients aged under 35 years (Abstract 101P_PR). Of all breast cancers, 5% occur in women under 35, making it the most common cancer in women of this age group.
In the study, 20% of tumors were triple-negative, 28% were HER2-positive, and 4% luminal A vs 67% luminal B, confirming the higher percentages of more aggressive tumor subtypes in young women. After a median follow-up of 53.5 months, 85% of women were alive, 26 patients had developed metastases, and 3 had a local recurrence.
Study author Ines F. Eiriz, MD, of the Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal, said, “Disease-free survival was longest in women with hormone receptor–positive tumors, followed by those with HER2-positive disease, and lastly, those with triple-negative breast cancer. The median survival of patients without metastases was 130 months compared to 37 months for those with metastatic disease.”
Disease Recurrence
A Swiss study (Abstract 102P_PR) looking at breast cancer recurrence in 359 women aged 50 years or younger showed that during a median follow-up of 45.6 months, 14 patients developed local recurrence, 6 developed distant metastases, and 9 developed both. The median time to recurrence was 31 months. The 3- and 5-year risks for local recurrence were 4.7% and 9.5%, respectively. Rates of disease-free survival were 94.3% and 91.2% at 3 and 5 years, respectively. The rate of overall survival at 5 years was 93%.
Study author Simona Cima, MD, of the IOSI–Oncology Institute of Southern Switzerland, said, “Most recurrences in these patients were local rather than metastatic. Our study is ongoing, and the next step is to identify predictors of local recurrence. For example, we will examine the likelihood of local recurrence according to HER2 and triple-negative status.”
Dr. Lambertini concluded, “It’s not true that being diagnosed with breast cancer at a young age means poorer survival or higher chances of the cancer coming back, and these studies further confirm that. Proper guideline-recommended treatments should be given to all [patients with] breast cancer, regardless of their age. Special attention should be paid in these women on the potential side effects of anticancer therapies, including the risk of infertility.”
Disclosure: For full disclosures of the study authors, visit cslide.ctimeetingtech.com/breast2019.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
