Women under 35 responded to neoadjuvant
chemotherapy better than older women, according to research using German
studies on 8,949 women with operable or locally advanced, nonmetastatic breast
cancer presented today at the 35th
annual San Antonio Breast Cancer Symposium.
The younger group included a greater proportion of triple-negative
breast cancer cases (26 percent) than the group of women older than 35 (21
percent). Luminal A cancers accounted
for 19 percent of all cases under 35 and 27 percent of those over 35.
The pathological complete response rate was significantly higher
in very young women — 23.6 percent compared with 15.7 percent among older
women. This difference was amplified in young women with triple-negative breast
cancer and those with luminal-like breast cancer.
Breast cancer might be
biologically different in very young women, even those who are
hormone-positive, according to Sibylle
Loibl, M.D., Ph.D., an associate professor at the University of Frankfurt in
Germany and the lead author of the paper.
Researchers found no difference in disease-free survival according
to age among those patients who achieved a pathological complete response.
However, disease-free survival was significantly worse among young women who
did not achieve a pathological complete response.
The younger group included a greater proportion of triple-negative
breast cancer cases (26 percent) than the group of women older than 35 (21
percent). Luminal A cancers accounted
for 19 percent of all cases under 35 and 27 percent of those over 35.
Luminal-like cancers tend
to be estrogen-positive; either progesterone-positive or progesterone-negative;
HER2-negative; and with low Ki67.
“Young women with breast cancer are rare, and
some data indicate that their prognosis is worse than it is for older women,” Loibl said. Tumors in young women are more likely to be
triple-negative.
Loibl says young women with TNBC and luminal-like
cancers will both benefit from neoadjuvant chemotherapy.
Read more about TNBC in my book, Surviving Triple-Negative Breast Cancer.
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