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METHODS
The pathology and cancer registry records of the Mount Sinai
Medical Center from 1989 to 1997 were reviewed to identify women
under age 36 at the time of diagnosis with breast cancer. From
123 patients, 15 were excluded because surgical treatment was
not completed at Mount Sinai, 5 patients were excluded because
they had distant metastases at diagnosis, and 2 patients were
missing information about treatment. The remaining 101 patients
were compared with 631 patients older than 35 whom we treated
for breast cancer during the same interval. Stage IV patients
were excluded.
Information was obtained from hospital and office records
and from patients and their families. The slides of the patients
under age 36 were reviewed by one of us (IJB). Staging
followed the criteria of the American Joint Commission on Cancer
Manual for Staging of Cancer.8
Information was collected on age, height, weight, race, age at
menarche, pregnancies, children, age at first birth, family history
of breast cancer, smoking, clinical presentation, mammographic
findings, mode of diagnosis, histopathologic findings, tumor
differentiation, tumor size, estrogen and progesterone receptors,
margins of resection, S phase, ploidy, surgical treatment, axillary
node involvement, and adjuvant chemotherapy and radiation therapy.
The last date of followup and the date of local or distant recurrence
were recorded. The local and distant disease-free survival was
calculated from the date of the definitive operation. For estimates
of local recurrence rates patients in whom a local recurrence
did not develop were censored at the earliest of last followup
or death. Similar definitions were used for the estimates of
distant disease-free survival.
The data were analyzed using the SPSS (Statistical Package
for Social Sciences; SPSS, Inc, Chicago, IL) statistical program.
The patients were divided into two groups by age and compared.
The significance of differences in categoric variables was evaluated
using chi-square tests, and the significance of differences in
continuous variables was evaluated using Student's t-test
or Wilcoxon's rank-sum test, as appropriate. Local
and distant disease-free survival curves were calculated using
the Kaplan-Meier method.9
The significance of differences in survival was evaluated using
the Breslow test. The Cox proportional hazards model was used
to evaluate the relative prognostic significance of each variable
for both local and distant recurrence. The influence of age at
operation was allowed to change with time because the apparent
prognostic influence of age was found to diminish during followup.
Introduction
| Methods | Results
| Discussion
| References
JACS |
