%0 Journal Article
%T Age determines the prognostic role of the cancer stem cell marker aldehyde dehydrogenase-1 in breast cancer
%A J Sven D Mieog
%A Esther M de Kruijf
%A Esther Bastiaannet
%A Peter JK Kuppen
%A Anita Sajet
%A Anton JM de Craen
%A Vincent THBM Smit
%A Cornelis JH van de Velde
%A Gerrit-Jan Liefers
%J BMC Cancer
%D 2012
%I BioMed Central
%R 10.1186/1471-2407-12-42
%X The study population (N = 574) consisted of all early breast cancer patients primarily treated with surgery in our center between 1985 and 1994. Median follow-up was 17.9 years (range: 0.1 to 23.5). Tissue microarray slides were immunohistochemically stained for ALDH1 expression and quantified by two independent observers who were blinded to clinical outcome. Assessment of the prognostic effect of ALDH1 expression was stratified according to age and systemic treatment.Complete lack of expression of ALDH1 was found in 40% of tumors. With increasing age more tumors showed complete absence of ALDH1 expression (P < .001). In patients aged > 65 years, ALDH1 status was not associated with any clinical outcome. Conversely, in patients aged < 65 years, ALDH1 positivity was an independent risk factor of worse outcome for relapse free period (hazard ratio = 1.71 (95% CI, 1.09 to 2.68); P = .021) and relative survival (relative excess risks of death = 2.36 (95% CI, 1.22 to 3.68); P = .016). Ten-year relative survival risk was 57% in ALDH1-positive patients compared to 83% in ALDH1-negative patients.ALDH1 expression and its prognostic effect are age-dependent. Our results support the hypothesis that breast cancer biology is different in elderly patients compared to their younger counterparts and emphasizes the importance of taking into consideration age-specific interactions in breast cancer research.Age at diagnosis of breast cancer is an important independent prognostic factor. Young age is associated with more aggressive tumors with a relatively high risk of distant metastasis and loco-regional recurrence [1], whereas old age is associated with more indolent tumors [2,3]. Although tumor characteristics differ considerably between age groups (including hormone receptor and human epidermal growth factor receptor 2 (HER2) status), these tumor characteristics can only account for part of the divergence in survival witnessed between age groups [3]. Little is known about the impac
%K Breast cancer
%K Age
%K ALDH1
%K Prognostic factor Part of this work has been presented at the American Association for Cancer Research (AACR) Annual Meeting 2011
%U http://www.biomedcentral.com/1471-2407/12/42