Breast Cancer in Young Women Poor Survival Despite Intensive Treatment 英文参考文献.docVIP

Breast Cancer in Young Women Poor Survival Despite Intensive Treatment 英文参考文献.doc

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Breast Cancer in Young Women Poor Survival Despite Intensive Treatment 英文参考文献

BreastCancerinYoungWomen:PoorSurvivalDespite IntensiveTreatment HannaFredholm1*,SonjaEaker2,3,JanFrisell1,LarsHolmberg2,4,IrmaFredriksson1.,HenrikLindman5. 1DepartmentofMolecularMedicineandSurgery,KarolinskaInstitute,KarolinskaUniversityHospital,Stockholm,Sweden,2RegionalOncologicCenter,UppsalaUniversity Hospital, Uppsala, Sweden, 3Department for Surgical Science, Uppsala University Hospital, Uppsala, Sweden, 4SchoolofMedicine,DivisionofCancerStudies,King’s CollegeLondon,London,UnitedKingdom,5DepartmentofOncology,RadiologyandClinicalImmunology,SectionofOncology,UppsalaUniversityHospital,Uppsala,Sweden Abstract Background: Breast cancer is uncommon in young women andcorrelates with aless favourable prognosis; stillit is the mostfrequentcancerinwomenunder40,accountingfor30–40%ofallincidentfemalecancer.Theaimofthisstudywasto study prognosis in young women, quantifying how much stage at diagnosis and management on the one hand, and tumourbiologyontheother;eachcontributetotheworseprognosisseeninthisagegroup. Methodology/PrincipalFindings:Inaregistrybasedcohortofwomenaged20–69(n=22017)withaprimarydiagnosisof invasivebreastcancer(1992–2005),womenaged20–34(n=471),35–39(n=858)and40–49(n=4789)werecomparedwith womenaged50–69years(n=15899).Thecumulative5-yearrelativesurvivalratioandtherelativeexcessmortality(RER) were calculated. The cumulative 5-year relative survival ratio was lowest in women aged 20–34. The RER was 2.84 for womenaged20–34anddecreasedwithincreasingage(RER1.76and1.17forwomenaged35–39and40–49,respectively). Theexcessriskwas,however,presentonlyindiseasestagesIandII.Forwomenaged20–34withstageIdiseaseRERwas 4.63,and6.70inthesubgroupwithtumoursize1–10mm.TheabsolutedifferenceinstageIbetweentheyoungestandthe referencegroupsamountedtonearly8%,witha90%5-yearsurvivalinwomenaged20–34.InstagesIIaandIIb,therelative excessriskwasnotasdramatic,buttheabsolutedifferencesapproached15%.Theyoungestwomenwithsmalltumours generallyreceivedmoreaggressivetreatmentthanwomeninolderagegr

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