Young age: an independent risk factor for disease-free survival in women with operable breast cancer

We retrospectively analyzed 2040 consecutive primary invasive breast cancer patients who underwent surgical procedures at our institution between 1990 and 1999. The younger age group was defined as patients aged <35 years at the time of diagnosis. The clinicopathological characteristics and treatment outcomes were compared between younger and older age groups.A total of 256 (12.5%) patients were aged <35. There was a significantly higher incidence of nuclear grade 3 and medullary histological-type tumors in younger patients compared to older patients. Axillary lymph node status, T stage, histological grade, c-erbB2 expression and estrogen receptor status did not differ significantly between the two age groups. Younger patients had a greater probability of recurrence and death at all time periods. Although there was no significant difference in disease-free survival between the two age groups in lymph node-negative patients, the younger group showed worse prognosis among lymph node-positive patients (p < 0.001). In multivariate analysis, young age remained a significant predictor of recurrence (p = 0.010).Young age (<35) is an independent risk factor for relapse in operable breast cancer patients.Breast cancer is relatively rare in women less than 35 years of age, with this group accounting for less than 4% of the total number of breast cancer cases diagnosed in Western countries [1,2]. Despite the disease being relatively uncommon, it has a severe negative effect on the patients and their families.It remains controversial whether young age at diagnosis is an adverse prognostic factor in primary breast cancer. While some studies have found that younger patients have worse clinical outcomes than older patients [3-7], others report younger patients have a more favorable prognosis, or that there is no relationship between outcome and age [8-10]. Various explanations have been given for these conflicting results, including small numbers of patients comprising the study p