Dataset Information

Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer.

ABSTRACT:

Background

Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available.

Methods

We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41-69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns.

Results

Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20-40). Compared with women aged 41-69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR-/HER2- disease known as "triple negative breast cancer" (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2- patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0-51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2-, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015).

Conclusion

De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

SUBMITTER: Mallet A

PROVIDER: S-EPMC8785354 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Real-world evidence of the management and prognosis of young women (⩽40 years) with <i>de novo</i> metastatic breast cancer.

Mallet Amélie A Lusque Amélie A Levy Christelle C Pistilli Barbara B Brain Etienne E Pasquier David D Debled Marc M Thery Jean Christophe JC Gonçalves Anthony A Desmoulins Isabelle I De La Motte Rouge Thibault T Faure Christelle C Ferrero Jean Marc JM Eymard Jean Christophe JC Mouret-Reynier Marie Ange MA Patsouris Anne A Cottu Paul P Dalenc Florence F Petit Thierry T Payen Olivier O Uwer Lionel L Guiu Séverine S Frenel Jean Sébastien JS

Therapeutic advances in medical oncology 20220121

<h4>Background</h4>Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. <i>De novo</i> metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available.<h4>Methods</h4>We evaluated management of women aged ⩽40 years with <i>de novo</i> MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare ...[more]

PMID: 35082924

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