Younger patients with breast cancer tend to have a poorer prognosis and higher rates of recurrence. A study presented at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting examined patterns of care and survival of this patient population in their community setting.
The researchers reviewed their institutional database to find 4,703 patients treated for breast cancer from 2006 to 2015 in their network, Ascension Macomb Oakland Hospital (AMOH), Ascension St. John Hospital (ASJH), and Ascension Providence Hospital (APH), in Warren, Michigan. They identified 319 people who were younger than 45 and reviewed their charts to understand tumor characteristics, type of surgery (mastectomy or breast-conserving surgery), and overall survival.
Of the total sample, 91 women received breast-conserving surgery (28.5%) and 228 (71.4%) received mastectomy (split almost evenly between unilateral and bilateral).
The median follow-up among surviving patients was 53 months, at which point 26 had died. Analysis indicated that African American women had lower rates of survival. Higher rates of overall survival were associated with lower stages per the American Joint Committee on Cancer staging system, positive estrogen or progesterone receptor testing, and negative human epidermal growth factor receptor 2 (HER2) status.
“In this group of young women, overall survival was influenced by stage and breast cancer phenotype, as expected. African American race was associated with inferior overall survival,” wrote the authors, led by Aye Thet. “We found high rates of mastectomy with or without reconstruction. In the future, comprehensive disease profiling will help to direct decision-making.