Impact of Age on Survival of Patients with Operable Breast Cancer

Background: Breast cancer arising in young patients (≤ 40 years) is being considered as a distinct clinical entity with more aggressive tumor features and poorer survival. Our aim was to assess the impact of age on survival among a large group of Iranian women diagnosed with breast cancer. Methods: In a cross-sectional study, demographic and clinicopathological characteristics of patients with breast cancer who were treated in two referral centers in Tehran, Iran during the past 13 years were reviewed and extracted from an electronic database. Patients were divided into two groups based on the age at the time of diagnosis (≤40 and >40 years). The association of age with different clinicopathological features and its impact on disease-free survival were assessed. Results: Study population comprised of 353(26.1%) patients who were 40 years old or younger and 1000(73.9%) who were older. Compared to older patients, younger participants had more commonly tumor size larger than 5 cm(P= 0.034), higher chance of lymph node metastasis (P= 0.036), and overexpression of HER-2 (P = 0.004). No significant differences were observed between the two groups regarding ER, PR, and LNR (lymph node ratio). Age was the only factor affecting patients' disease-free survival and younger patients had higher chance of local or distant metastases compared to older subjects (HR: 1.49, 95%CI: 1.02- 2.17, P= 0.038). Conclusions: Based on the results of current study, it can be suggested that younger patients who are diagnosed with breast cancer tend to have larger tumor size, higher chance of lymph node metastasis and overexpression of HER-2 compared to patients older than 40 years. Age was the only significant factor that was associated with shorter disease-free survival.