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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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