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- Title
Prospective Observational Study of Breast Cancer Treatment Outcomes for UK Women Aged 18-40Years at Diagnosis: The POSH Study.
- Authors
Copson, Ellen; Eccles, Bryony; Maishman, Tom; Gerty, Sue; Stanton, Louise; Cutress, Ramsey I.; Altman, Douglas G.; Durcan, Lorraine; Simmonds, Peter; Lawrence, Gill; Jones, Louise; Bliss, Judith; Eccles, Diana
- Abstract
Background Breast cancer at a young age is associated with poor prognosis. The Prospective Study of Outcomes in Sporadic and Hereditary Breast Cancer (POSH) was designed to investigate factors affecting prognosis in this patient group. Methods Between 2000 and 2008, 2956 patients aged 40 years or younger were recruited to a UK multicenter prospective observational cohort study (POSH). Details of tumor pathology, disease stage, treatment received, and outcome were recorded. Overall survival (OS) and distant disease-free interval (DDFI) were assessed using Kaplan-Meier curves. Ail statistical tests were two-sided. Results Median age of patients was 36 years. Median tumor diameter was 22 mm, and 50% of patients had positive lymph nodes; 59% of tumors were grade 3, 33.7% were estrogen receptor (ER) negative, and 24% were human epidermal growth factor receptor 2 (HER2) positive. Five-year OS was higher for patients with ER-positive than ER-negative tumors (85.0%, 95% confidence interval [CI] = 83.2% to 86.7% vs 75.7%, 95% CI = 72.8% to 78.4%; P < .001), but by eight years, survival was almost equal. The eight-year OS of patients with ER-positive tumors was similar to that of patients with ER-negative tumors in both HER2-positive and HER2-negative subgroups. The flexible parametric survival model for OS shows that the risk of death increases steadily over time for patients with ER-positive tumors in contrast to patients with ER-negative tumors, where risk of death peaked at two years. Conclusions These results confirm the increased frequency of ER-negative tumors and early relapse in young patients and also demonstrate the equally poor longer-term outlook of young patients who have ER-positive tumors with HER2-negative or -positive disease.
- Subjects
UNITED Kingdom; BREAST cancer treatment; CANCER in women; CANCER diagnosis; WOMEN; CANCER research
- Publication
JNCI: Journal of the National Cancer Institute, 2013, Vol 105, Issue 13, p978
- ISSN
0027-8874
- Publication type
Article
- DOI
10.1093/jnci/djt134