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Journal of Breast Disease > Volume 8(1); 2020 > Article
Journal of Breast Disease 2020;8(1): 1-8. doi: https://doi.org/10.14449/jbd.2020.8.1.1
원격전이가 발생한 폐경전 여성 유방암 환자에서의 예후인자
성정호, M.D., 유재민, M.D., Ph.D.1, 남석진, M.D., Ph.D.1, 이정언, M.D., Ph.D.1, 유종한, M.D., Ph.D.1, 이세경, M.D., Ph.D.1, 채병주, M.D., Ph.D.1, 김석원, M.D., Ph.D.1
성균관대학교 의과대학 삼성서울병원 외과
1성균관대학교 의과대학 삼성서울병원 유방외과 분과
Prognostic Factors for Premenopausal Women with Distant Metastatic Breast Cancer
Jeungho Seung, M.D., Jai Min Ryu, M.D., Ph.D.1, Seok Jin Nam, M.D., Ph.D.1, Jeong Eon Lee, M.D., Ph.D.1, Jonghan Yu, M.D., Ph.D.1, Se Kyung Lee, M.D., Ph.D.1, Byung Joo Chae, M.D., Ph.D.1, Seok Won Kim, M.D., Ph.D.1
Department of Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
1Department of Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Corresponding Author: Seok Won Kim ,Tel: +82-2-3410-3726, Fax: +82-2-3410-0040, Email: seokwon1.kim@samsung.com
Received: September 17, 2019    Revised: November 8, 2019    Accepted: February 18, 2020
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ABSTRACT
Purpose: Several studies have reported that the survival after distant metastasis in younger patients with breast cancer was similar to that in elderly patients. Moreover, few studies have observed better survival outcome after distant metastasis in younger patients with breast cancer. Here, we have identified the factors that affect the prognosis after distant metastasis in these patients.
Methods: We reviewed 7,157 patients that underwent primary breast cancer surgery between January 2003 and December 2013 at the Samsung Medical Center. Three hundred and thirty two premenopausal patients aged <50 years showed distant metastasis and were included in the analysis. For further analysis, the patients older or younger than 40 years were divided into 2 groups.
Results: There were no demographic differences in the patient characteristics such as clinical stage, nuclear grade, lymphovascular invasion, distant metastasis site, distant metastasis free interval (DMFI), except the estrogen receptor (ER) and progesterone receptor (PR) statuses, histopathology, and molecular subtype in both the groups (p-value=0.023, 0.035, 0.016, 0.046, respectively). The median follow-up period was 79.4 months. Next, we did not observe significant difference in the overall survival (OS) between the two groups (Log rank p-value=0.975). However, patients in the luminal A and luminal B group showed better OS than those in human epidermal growth factor receptor-2 (HER-2) positive, and triple-negative breast cancer (TNBC) group (Log-rank p-value<0.001). Furthermore, patients showed worse OS when they developed distant metastases within 36 months post-surgery (Log-rank p-value<0.001). In overall, age did not affect the survival outcome (p-value=0.547); however, the molecular subtype, DMFI, and distant metastasis sites showed significant differences in the patient outcome (p-value<0.001, respectively).
Conclusions: Our analysis suggests that the molecular subtype, DMFI, and distant metastasis site serve as useful predictors for prognosis in younger breast cancer patients with distant metastasis. However, age in these patients did not correlate well with mortality.
Keywords: Breast neoplasms | Neoplasm metastasis | Premenopause | Prognosis | Survival
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