Background. Tumour characteristics are the most important prognostic factors in breast cancer. Patient-related factors such as young age at diagnosis, obesity, and smoking behaviour may also modify disease outcome. Due to the absence of a unique definition for “young age breast cancer” and the resulting variation in disease management, findings on the association between young age and prognosis of breast cancer are controversial. Methods. This study included 1500 patients with a primary diagnosis of breast cancer in six Iranian hospitals from 5 provinces. We modelled the relative excess risk (RER) of breast cancer death to age at diagnosis and tumour characteristics. Results. Excess risks of death were observed for stage IV disease and poorly differentiated tumours: RER of 4.3 (95% CI: 1.05–17.65) and 3.4 (95% CI: 1.17–9.87), respectively. “Older” patients, particularly those aged 50 and over, presented more often with advanced and poorly differentiated tumours ( ). After adjustment for stage, histological grade, Her-2 expression, estrogen and progesterone receptors, and place of residency, breast cancer mortality was not significantly different across age groups. Conclusion. We conclude that there is no prognostic effect of age at diagnosis of breast cancer among breast cancer patients treated at cancer centres in different parts of Iran; young and relatively old women have similar risks of dying from breast cancer. 1. Background Tumour characteristics such as size, tumour grade, receptor status, and lymph node involvement are known to be the most important prognostic factors in breast cancer [1, 2]. Patient-related factors such as obesity, cigarette smoking, alcohol consumption, and age may modify disease outcome [3–6]. The prognostic value of age at diagnosis is particularly controversial due to the fact that there is no worldwide consensus on age boundaries for the definition of “young” age breast cancer. In the literature, the cut-off point of young age varies and has been set at age, 30, 35, 40, and 45. As a consequence, variation in disease management may occur in patients of similar age. Most reports on risks of young age breast cancer come from western countries with small proportions of young patients [7–13]. Some of these studies suggested that negative prognostic influence of young age is thought to be related to the less favourable tumour characteristics as presented by young women. However, neither the worse influence in its own nor the factors that have been suggested to explain the influence of young age are universally accepted. In
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