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The influence of young age at diagnosis on prognosis of patients with metastatic breast cancer (MBC) remains unclear. We examined overall survival (OS) within a single-institution prospective study of patients with de novo or recurrent MBC. Kaplan-Meier curves assessed OS by age (≤35 or ≤40 years as the youngest category) and inferred metastatic tumor subtype. Multivariable Cox regression models estimated hazard ratios (HRs) and 95% CIs for OS by age adjusting for clinical factors. Of 4189 women <75 years, 571 were ≤40 years at MBC diagnosis, of whom 260 were ≤35 years. Over half (52%) died during follow-up (median = 5.3 years, IQR = 2.1–9.8 years). Compared to patients 45–55 years, those ≤35 years at diagnosis experienced worse OS (HR = 1.22, 95%CI 1.00–1.48, p = 0.05). This association was driven by HER2-negative/luminal B-like and hormone receptor-positive/HER2-positive tumors. These findings highlight the need to develop more effective therapies for young patients with this metastatic subtype.
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1 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA (ROR: https://ror.org/02jzgtq86) (GRID: grid.65499.37) (ISNI: 0000 0001 2106 9910); Department of Medicine, Harvard School of Medicine, Boston, MA, USA (ROR: https://ror.org/03vek6s52) (GRID: grid.38142.3c) (ISNI: 000000041936754X)
2 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA (ROR: https://ror.org/02jzgtq86) (GRID: grid.65499.37) (ISNI: 0000 0001 2106 9910); Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA (ROR: https://ror.org/05rgrbr06) (GRID: grid.417747.6) (ISNI: 0000 0004 0460 3896)
3 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA (ROR: https://ror.org/02jzgtq86) (GRID: grid.65499.37) (ISNI: 0000 0001 2106 9910); Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA (ROR: https://ror.org/05rgrbr06) (GRID: grid.417747.6) (ISNI: 0000 0004 0460 3896); Yale Cancer Center, New Haven, CT, USA (ROR: https://ror.org/03j7sze86) (GRID: grid.433818.5) (ISNI: 0000 0004 0455 8431)
4 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA (ROR: https://ror.org/02jzgtq86) (GRID: grid.65499.37) (ISNI: 0000 0001 2106 9910); Department of Medicine, Harvard School of Medicine, Boston, MA, USA (ROR: https://ror.org/03vek6s52) (GRID: grid.38142.3c) (ISNI: 000000041936754X); Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA (ROR: https://ror.org/05rgrbr06) (GRID: grid.417747.6) (ISNI: 0000 0004 0460 3896)
5 Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA (ROR: https://ror.org/02jzgtq86) (GRID: grid.65499.37) (ISNI: 0000 0001 2106 9910)