Work

Incidence and survival among young women with stage I-III breast cancer

Year: 2018

Type: article

Abstract: Background: De novo Stage IV breast cancer (BC) is increasing in premenopausal women. Less is known about current incidence and survival among these women with Stage I-III BC. Methods: Women ages 20-29 (N = 3,826), 30-39 (N = 34,585), 40-49 (N = 126,552) and 50-59 (N = 172,448) diagnosed with Stage I-III BC from 2000-15 were identified from the US Surveillance, Epidemiology and End Results database. Age-adjusted, annual percentage changes (APC) in incidence and 10-year Kaplan-Meier survival curves were estimated by stage, hormone receptor (HR) status, and grade (low: well/moderately differentiated; high: poorly/undifferentiated) for each age decade. Results: Stage III BC at presentation decreased with age (20-29 [23.9%], 30-39 [21.9%], 40-49 [16.1%], 50-59 [14.1%]); the opposite pattern was observed for Stage I (23.6%, 28.8%, 42.0%, 48.3%, respectively). HR+ high grade and HR- BCs also decreased with age (20-29 [34.5%, 36.5%], 30-39 [31.1%, 31.6%], 40-49 [23.9%, 21.4%], 50-59 [20.9%, 21.1%]). Among all BC presentations, age-adjusted APC in incidence was higher for women 20-29 (1.6) than those 30-39 (0.3), 40-49 (0.3) or 50-59 (-1.1). Incidence of HR+ low and high-grade BC increased for women <50 with the highest APC (5.7 and 3.8, respectively) for women 20-29; HR- BC incidence decreased for all ages. Among women 20-29, 10-year survival was lowest for those with HR+ high grade BC (Table); for this group, the greatest survival difference between HR+ high grade and HR- BC was for Stage I BC (79.8% vs 89.3%) compared to Stage II (77.2% vs 80.7%) or Stage III (44.9% vs 45.0%). Comparing Stage III BC across age decades, 10-year survival was lowest for women 20-29, notably for HR+ BC.Table: 245PStageHR StatusGrade10-Year Survival % (Standard Error)Age (years)20-2930-3940-4950-59Any+Low81.2 (1.9)85.4 (0.5)91.1 (0.2)89.2 (0.1)+High67.7 (2.0)75.3 (0.6)80.2 (0.3)77.1 (0.3)-73.8 (1.5)74.3 (0.5)75.1 (0.3)74.3 (0.3)Stage III+Low54.2 (5.7)62.8 (1.6)73.7 (0.7)68.3 (0.7)+High44.9 (3.9)55.7 (1.3)60.1 (0.8)54.2 (0.8)-45.0 (3.5)49.2 (1.2)49.8 (0.8)47.5 (0.7) Open table in a new tab Conclusions: Among young women, HR+ BC is increasing in incidence and associated with reduced survival for those 20-29. Understanding the etiologies underlying these trends may inform strategies directed toward improving outcomes for these women. Legal entity responsible for the study: University of Iowa. Funding: United States Centers for Disease Control and Prevention (U01DD001035) and the Nealie Belk Stevens Fund for Breast Cancer Research. Disclosure: All authors have declared no conflicts of interest.

Source: Annals of Oncology

DOI: 10.1093/annonc/mdy270.240