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Incidence and prognosis in early onset breast cancer
Department of Surgery, County Hospital, Kalmar, Sweden.
Department of Cytology and Pathology, County Hospital, Kalmar, Sweden.
Department of Cytology and Pathology, County Hospital, Kalmar, Sweden.
Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
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2002 (English)In: Breast, ISSN 0960-9776, E-ISSN 1532-3080, Vol. 11, no 1, 30-35 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to assess the incidence and prognosis in early onset breast cancer. Age-adjusted incidence and death rate for the 5394 Swedish women diagnosed with breast cancer under the age of 40 between 1960 and 1996 was studied using data from the Swedish Cancer Registry and Swedish Death Cause Registry. A total of 107 consecutive young patients with invasive breast cancer undergoing surgery during 1980–1993 in the Southeast Swedish health care region were retrospectively followed up and their cancers reviewed and graded blindly. The median follow-up time was 11.2 years. The applicability of the Nottingham Prognostic Index (NPI) as a prognostic tool was investigated. Grade, age, node status, tumour size, S-phase fraction and steroid receptor content were related to survival univariately and multivariately in a Cox proportional hazard analysis.

The incidence of early onset breast cancer has increased moderately and the survival rate has not improved during the last 35 years. When young women are diagnosed with breast cancer their tumours are larger, their lymph nodes more often involved, and the median grade higher than in older with 64% having grade 3 tumours. Lymph node status was the strongest sole prognostic indicator but the use of NPI gave more accurate prognostic information than node status alone.

Place, publisher, year, edition, pages
2002. Vol. 11, no 1, 30-35 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-28170DOI: 10.1054/brst.2001.0358Local ID: 12986OAI: oai:DiVA.org:liu-28170DiVA: diva2:248721
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-09Bibliographically approved
In thesis
1. Prognostic Factors in Breast Cancer
Open this publication in new window or tab >>Prognostic Factors in Breast Cancer
2000 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Breast cancer is increasing in the industrialised countries. Due to early detection and adjuvaut treatment with radiotherapy, hormones and chemotherapy, mortality has decreased. The different adjuvant treatments have adverse effects. It is an important task is to estimate the risk of recurrence for the individual patient in order to tailor her individual treatment. This thesis aims at identifying predictors for disease development in primary and disseminated breast cancer.

Histologic grade was strongly correlated to breast cancer mortality in 630 patients with primary breast cancer. The combination of grade, tumour size and lymph node status in the Nottingham Prognostic Index provides a powerful instrument separating patients in groups with excellent, good, intermediate and poor prognosis.

Grade was more sensitive than S-phase fraction in identifying high risk patients and patients with very good prognosis.

Presence of cancer cells in blood- and lymph vessels close to the tumour in patients with grade 3 tumours increased the risk oflocoregional recurrence 6-fold as compared to patients with grade 1 or 2 tumours without such vascular invasion.

The mortality of young women with breast cancer has decreased very little since 1960. Women under 37 years of age had increased tumour size, more metastatic lymph nodes and doubled rate of high grade tumours as compared to older women.

Disease-free interval and survival in patients with distant recurrence were strongly associated to histologic grade and hormone receptor content. Patients with grade 3, hormone receptor negative tumours had a median survival of 10 months after recurrence while only 15 % of women with receptor positive, grade 1 tumours have so far died after a median follow-up time of 5 years after recurrence.

The Nottingham Prognostic Index and assessments of presence of tmnour cells in vessels provide important information about the risk oflocoregional and distant recurrence in breast cancer. Treatment decisions, counselling and follow-up programmes should be based on such assessments. For patients with metastatic breast cancer, tumour grade, estrogen receptor status and serum-c-erbB-2 predict the course of the disease.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2000. 64 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 632
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25716 (URN)10093 (Local ID)91-7219-589-4 (ISBN)10093 (Archive number)10093 (OAI)
Public defence
2000-05-26, Ögonklinikens föreläsningssal, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-08-09Bibliographically approved

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Sundquist, MarieThorstenson, StenBrudin, LarsWingren, StenNordenskjöld, Bo

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