Breast cancer in young black women

Background: Young age at breast cancer diagnosis is associated with negative prognostic outcomes, and breast cancer in black women often manifests at a young age. This study evaluated the effect of age on breast cancer management and outcomes in black women. Methods: This was a retrospective cohort study of all black women treated for invasive breast cancer between 2005 and 2010 at a specialized tertiary-care cancer centre. Clinical and treatment characteristics were compared by age. Kaplan-Meier methodology was used to estimate overall survival (OS) and disease-free survival (DFS). Results: A total of 666 black women were identified. Median BMI was 30 (range 17-56) kg/m(2) and median tumour size was 16 (1-155) mm. Most tumours were oestrogen receptor-positive (66 center dot 4 per cent). Women were stratified by age: less than 40 years (74, 11 center dot 1 per cent) versus 40 years or more (592, 88 center dot 9 per cent). Younger women were significantlymore likely to have amastectomy, axillary lymph node dissection and to receive chemotherapy, and were more likely to have lymphovascular invasion and positive lymph nodes, than older women. The 5-year OS rate was 88 center dot 0 (95 per cent c.i. 86 center dot 0 to 91 center dot 0) per cent and the 5-year DFS rate was 82 center dot 0 (79 center dot 0 to 85 center dot 0) per cent. There was no statistically significant difference in OS by age (P = 0 center dot 236). Although DFS was inferior in younger women on univariable analysis (71 versus 88 per cent; P < 0 center dot 001), no association was found with age on multivariable analysis. Conclusion: Young black women with breast cancer had more adverse pathological factors, received more aggressive treatment, and had worse DFS on univariable analysis. Young age at diagnosis was, however, not an independent predictor of outcome.