Association Between Age at Presentation and Pathological Features of Breast Cancer and its Effect on Survival; a Comparative Study done in Sri Lanka

Abstract

Objective: The young age at presentation of breast can- cer (BC) is an independent prognostic factor of poor survival. Therefore the aim of this study was to deter- mine the association between age at presentation and the clinicopathological features of BC and to assess the im- pact of this association on the breast cancer specific sur- vival (BCSS) of different age groups. Methods: This retrospective study included all BC pa- tients who had sought the services of our unit from May 2006 to December 2012. Data were collected through follow up visits, clinic and laboratory records. BCSS was calculated from the date of BC diagnosis to the last fol- low up date or the event: death due to BC. Analysis was done using Pearson chi-square, Kaplan-Meier and Cox- regression models. Results: A total of 944 subjects were grouped according to the age at presentation; ≤ 35 years (7%), 36-60 years (70%) and >60 years (23%). The prevalence of duct car- cinoma in situ, tumour size, lymph node stage (LNS), lympho-vascular invasion and Nottingham prognostic index decreased as the age at presentation increased (p<0.05). Multivariate analysis revealed that LNS is the single factor affecting the BCSS of all groups. BCSS of each group was influenced by one or two additional fac- tors (tumour size for ≤35 years; progesterone receptor and Her2 status for 36-60 years group and estrogen re- ceptor status for >60 years). Conclusions: Poor prognostic features are prevalent among the ≤35 years group. LNS is the single most im- portant independent predictor of BCSS irrespective of the age at presentation.