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Breast Cancer Research
Published in: Breast Cancer Research 2/2012

Open Access 01-04-2012 | Research article

Occurrence of breast cancer subtypes in adolescent and young adult women

Authors: Theresa HM Keegan, Mindy C DeRouen, David J Press, Allison W Kurian, Christina A Clarke

Published in: Breast Cancer Research | Issue 2/2012

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Abstract

Introduction

Breast cancers are increasingly recognized as heterogeneous based on expression of receptors for estrogen (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2). Triple-negative tumors (ER-/PR-/HER2-) have been reported to be more common among younger women, but occurrence of the spectrum of breast cancer subtypes in adolescent and young adult (AYA) women aged between 15 and 39 years is otherwise poorly understood.

Methods

Data regarding all 5,605 AYA breast cancers diagnosed in California during the period 2005 to 2009, including ER and PR status (referred to jointly as hormone receptor (HR) status) and HER2 status, was obtained from the population-based California Cancer Registry. Incidence rates were calculated by subtype (triple-negative; HR+/HER2-; HR+/HER2+; HR-/HER2+), and logistic regression was used to evaluate differences in subtype characteristics by age group.

Results

AYAs had higher proportions of HR+/HER2+, triple-negative and HR-/HER2+ breast cancer subtypes and higher proportions of patients of non-White race/ethnicity than did older women. AYAs also were more likely to be diagnosed with stage III/IV disease and high-grade tumors than were older women. Rates of HR+/HER2- and triple-negative subtypes in AYAs varied substantially by race/ethnicity.

Conclusions

The distribution of breast cancer subtypes among AYAs varies from that observed in older women, and varies further by race/ethnicity. Observed subtype distributions may explain the poorer breast cancer survival previously observed among AYAs.
Appendix
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Literature
1.
Bleyer A, Barr R, Hayes-Lattin B, Thomas D, Ellis C, Anderson B: The distinctive biology of cancer in adolescents and young adults. Nat Rev Cancer. 2008, 8: 288-298. 10.1038/nrc2349.CrossRefPubMed
2.
3.
Gnerlich JL, Deshpande AD, Jeffe DB, Sweet A, White N, Margenthaler JA: Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease. J Am Coll Surg. 2009, 208: 341-347. 10.1016/j.jamcollsurg.2008.12.001.CrossRefPubMedPubMedCentral
4.
Kurian A, Fish K, Shema S, Clarke C: Lifetime risks of specific breast cancer subtypes among women in four racial/ethnic groups. Breast Cancer Res. 2010, 12: R99-10.1186/bcr2780.CrossRefPubMedPubMedCentral
5.
Schmidt C: Lack of progress in teen and young adult cancers concerns researchers, prompts study. J Natl Cancer Inst. 2006, 98: 1760-1763. 10.1093/jnci/djj517.CrossRefPubMed
6.
Telli ML, Chang ET, Kurian AW, Keegan TH, McClure LA, Lichtensztajn D, Ford JM, Gomez SL: Asian ethnicity and breast cancer subtypes: a study from the California Cancer Registry. Breast Cancer Res Treat. 2011, 127: 471-478. 10.1007/s10549-010-1173-8.CrossRefPubMed
7.
Amirikia KC, Mills P, Bush J, Newman LA: Higher population-based incidence rates of triple-negative breast cancer among young African-American women: jmplications for breast cancer screening recommendations. Cancer. 2011, 117: 2747-2753. 10.1002/cncr.25862.CrossRefPubMedPubMedCentral
8.
Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V: Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California Cancer Registry. Cancer. 2007, 109: 1721-1728. 10.1002/cncr.22618.CrossRefPubMed
9.
Parise CA, Bauer KR, Caggiano V: Variation in breast cancer subtypes with age and race/ethnicity. Crit Rev Oncol Hematol. 2010, 76: 44-52. 10.1016/j.critrevonc.2009.09.002.CrossRefPubMed
10.
Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, Karaca G, Troester MA, Tse CK, Edmiston S: Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. J Am Med Assoc. 2006, 295: 2492-10.1001/jama.295.21.2492.CrossRef
11.
Bernstein L, Lacey JV: Receptors, associations, and risk factor differences by breast cancer subtypes: positive or negative?. J Natl Cancer Inst. 2011, 103: 451-453. 10.1093/jnci/djr046.CrossRefPubMed
12.
California Cancer Reporting System Standards: Cancer Reporting in California, System Standards: Abstracting and Coding Procedures for Hospitals. 2008, Sacramento: California Cancer Registry, Data Standards and Quality Control Unit, 1: 8
13.
Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lonning PE, Borresen-Dale AL, Brown PO, Botstein D: Molecular portraits of human breast tumours. Nature. 2000, 406: 747-752. 10.1038/35021093.CrossRefPubMed
14.
Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Eystein Lonning P, Borresen-Dale AL: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001, 98: 10869-10874. 10.1073/pnas.191367098.CrossRefPubMedPubMedCentral
15.
16.
Ruggles S, Sobek M, Alexander T, Fitch CA, Goeken R, Hall PK, King M, Ronnander C: Integrated Public Use Microdata Series: version 4.0. 2009, Minneapolis, MN
17.
18.
Dawood S, Hu R, Homes MD, Collins LC, Schnitt SJ, Connolly J, Colditz GA, Tamimi RM: Defining breast cancer prognosis based on molecular phenotypes: results from a large cohort study. Breast Cancer Res Treat. 2011, 126: 185-192. 10.1007/s10549-010-1113-7.CrossRefPubMed
19.
Joslyn SA, Foote ML, Nasseri K, Coughlin SS, Howe HL: Racial and ethnic disparities in breast cancer rates by age: NAACCR Breast Cancer Project. Breast Cancer Res Treat. 2005, 92: 97-105. 10.1007/s10549-005-2112-y.CrossRefPubMed
20.
Brinton LA, Sherman ME, Carreon JD, Anderson WF: Recent trends in breast cancer among younger women in the United States. J Natl Cancer Inst. 2008, 100: 1643-10.1093/jnci/djn344.CrossRefPubMedPubMedCentral
21.
Ihemelandu CU, Naab TJ, Mezghebe HM, Makambi KH, Siram SM, Leffall LD, DeWitty RL, Frederick WA: Treatment and survival outcome for molecular breast cancer subtypes in black women. Ann Surg. 2008, 247: 463-469. 10.1097/SLA.0b013e31815d744a.CrossRefPubMed
22.
Reynolds P, Hurley S, Goldberg D, Quach T, Rull R, Von Behren J: An excess of breast cancer among young California-born Asian women. Ethn Dis. 2011, 21: 196-201.PubMed
23.
Shavers VL, Harlan LC, Stevens JL: Racial/ethnic variation in clinical presentation, treatment, and survival among breast cancer patients under age 35. Cancer. 2003, 97: 134-147. 10.1002/cncr.11051.CrossRefPubMed
24.
Anderson WF, Jatoi I, Sherman ME: Qualitative age interactions in breast cancer studies: mind the gap. J Clin Oncol. 2009, 27: 5308-10.1200/JCO.2009.22.9450.CrossRefPubMedPubMedCentral
25.
Heron M, Sutton PD, Xu J, Ventura SJ, Strobino DM, Guyer B: Annual summary of vital statistics: 2007. Pediatrics. 2010, 125: 4-15. 10.1542/peds.2009-2416.CrossRefPubMed
26.
Krieger N, Chen JT, Waterman PD: Temporal trends in the black/white breast cancer case ratio for estrogen receptor status: disparities are historically contingent, not innate. Cancer Causes Control. 2011, 22: 511-514. 10.1007/s10552-010-9710-7.CrossRefPubMed
27.
Phipps AI, Chlebowski RT, Prentice R, McTiernan A, Stefanick ML, Wactawski-Wende J, Kuller LH, Adams-Campbell LL, Lane D, Vitolins M, Kabat GC, Rohan TE, Li CI: Body size, physical activity, and risk of triple-negative and estrogen receptor-positive breast cancer. Cancer Epidemiol Biomarkers Prev. 2011, 20: 454-463. 10.1158/1055-9965.EPI-10-0974.CrossRefPubMedPubMedCentral
28.
Phipps AI, Chlebowski RT, Prentice R, McTiernan A, Wactawski-Wende J, Kuller LH, Adams-Campbell LL, Lane D, Stefanick ML, Vitolins M, Kabat GC, Rohan TE, Li CI: Reproductive history and oral contraceptive use in relation to risk of triple-negative breast cancer. J Natl Cancer Inst. 2011, 103: 470-477. 10.1093/jnci/djr030.CrossRefPubMedPubMedCentral
29.
Phipps AI, Malone KE, Porter PL, Daling JR, Li CI: Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer. Cancer. 2008, 113: 1521-1526. 10.1002/cncr.23786.CrossRefPubMedPubMedCentral
30.
Kurian AW: BRCA1 and BRCA2 mutations across race and ethnicity: distribution and clinical implications. Curr Opin Obstet Gynecol. 2010, 22: 72-78. 10.1097/GCO.0b013e328332dca3.CrossRefPubMed
31.
Yang XR, Chang-Claude J, Goode EL, Couch FJ, Nevanlinna H, Milne RL, Gaudet M, Schmidt MK, Broeks A, Cox A, Fasching PA, Hein R, Spurdle AB, Blows F, Driver K, Flesch-Janys D, Heinz J, Sinn P, Vrieling A, Heikkinen T, Aittomaki k, Heikkila P, Blomquist Cj, Lissowska J, Peplonska B, Chanock S, Figueroa J, Brinton L, Hall P, Czene K, et al: Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the Breast Cancer Association Consortium Studies. J Natl Cancer Inst. 2011, 103: 250-263. 10.1093/jnci/djq526.CrossRefPubMed
32.
Travis LB, Hill D, Dores GM, Gospodarowicz M, Van Leeuwen FE, Holowaty E, Glimelius B, Andersson M, Pukkala E, Lynch CF: Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma. J Natl Cancer Inst. 2005, 97: 1428-10.1093/jnci/dji290.CrossRefPubMed
33.
Althuis MD, Brogan DD, Coates RJ, Daling JR, Gammon MD, Malone KE, Schoenberg JB, Brinton LA: Breast cancers among very young premenopausal women (United States). Cancer Causes Control. 2003, 14: 151-160. 10.1023/A:1023006000760.CrossRefPubMed
34.
Michels KB, Terry KL, Willett WC: Longitudinal study on the role of body size in premenopausal breast cancer. Arch Intern Med. 2006, 166: 2395-2402. 10.1001/archinte.166.21.2395.CrossRefPubMed
35.
Ahn MK, Juon HS, Gittelsohn J: Association of race/ethnicity, socioeconomic status, acculturation, and environmental factors with risk of overweight among adolescents in California, 2003. Prev Chronic Dis. 2008, 5: A75-PubMedPubMedCentral
36.
Babey SH, Hastert TA, Wolstein J, Diamant AL: Income disparities in obesity trends among California adolescents. Am J Public Health. 2010, 100: 2149-2155. 10.2105/AJPH.2010.192641.CrossRefPubMedPubMedCentral
37.
Gaudet MM, Press MF, Haile RW, Lynch CF, Glaser SL, Schildkraut J, Gammon MD, Douglas Thompson W, Bernstein JL: Risk factors by molecular subtypes of breast cancer across a population-based study of women 56 years or younger. Breast Cancer Res Treat. 2011, 130: 587-597. 10.1007/s10549-011-1616-x.CrossRefPubMedPubMedCentral
38.
Malone KE, Daling JR, Neal C, Suter NM, O'Brien C, Cushing-Haugen K, Jonasdottir TJ, Thompson JD, Ostrander EA: Frequency of BRCA1/BRCA2 mutations in a population-based sample of young breast carcinoma cases. Cancer. 2000, 88: 1393-1402. 10.1002/(SICI)1097-0142(20000315)88:6<1393::AID-CNCR17>3.0.CO;2-P.CrossRefPubMed
39.
Gonzalez KD, Noltner KA, Buzin CH, Gu D, Wen-Fong CY, Nguyen VQ, Han JH, Lowstuter K, Longmate J, Sommer SS, Weitzel JN: Beyond Li Fraumeni syndrome: clinical characteristics of families with p53 germline mutations. J Clin Oncol. 2009, 27: 1250-1256. 10.1200/JCO.2008.16.6959.CrossRefPubMed
40.
Turner NC, Reis-Filho JS: Basal-like breast cancer and the BRCA1 phenotype. Oncogene. 2006, 25: 5846-5853. 10.1038/sj.onc.1209876.CrossRefPubMed
41.
Haffty B, Choi D, Goyal S, Silber A, Ranieri K, Matloff E, Lee M, Nissenblatt M, Toppmeyer D, Moran M: Breast cancer in young women (YBC): prevalence of BRCA1/2 mutations and risk of secondary malignancies across diverse racial groups. Ann Oncol. 2009, 20: 1653-10.1093/annonc/mdp051.CrossRefPubMed
42.
Melhem-Bertrandt A, Bojadzieva J, Ready KJ, Obeid E, Liu DD, Gutierrez-Barrera AM, Litton JK, Olopade OI, Hortobagyi GN, Strong LC, Arun BK: Early onset HER2-positive breast cancer is associated with germline TP53 mutations. Cancer. 2012, 118: 908-913. 10.1002/cncr.26377.CrossRefPubMed
43.
Fredholm H, Eaker S, Frisell J, Holmberg L, Fredriksson I, Lindman H: Breast cancer in young women: poor survival despite intensive treatment. PLoS One. 2009, 4: e7695-10.1371/journal.pone.0007695.CrossRefPubMedPubMedCentral
44.
Agnese DM, Yusuf F, Wilson JL, Shapiro CL, Lehman A, Burak WE: Trends in breast cancer presentation and care according to age in a single institution. Am J Surg. 2004, 188: 437-439. 10.1016/j.amjsurg.2004.06.029.CrossRefPubMed
45.
Hede K: Breast cancer testing scandal shines spotlight on black box of clinical laboratory testing. J Natl Cancer Inst. 2008, 100: 836-837. 10.1093/jnci/djn200. 844CrossRefPubMed
46.
Ma H, Luo J, Press MF, Wang Y, Bernstein L, Ursin G: Is there a difference in the association between percent mammographic density and subtypes of breast cancer? Luminal A and triple-negative breast cancer. Cancer Epidemiol Biomarkers Prev. 2009, 18: 479-485. 10.1158/1055-9965.EPI-08-0805.CrossRefPubMed
47.
Press MF, Sauter G, Bernstein L, Villalobos IE, Mirlacher M, Zhou JY, Wardeh R, Li YT, Guzman R, Ma Y, Sullivan-Halley J, Santiago A, Park JM, Riva A, Slamon DJ: Diagnostic evaluation of HER-2 as a molecular target: an assessment of accuracy and reproducibility of laboratory testing in large, prospective, randomized clinical trials. Clin Cancer Res. 2005, 11: 6598-6607. 10.1158/1078-0432.CCR-05-0636.CrossRefPubMed
48.
Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FC, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, et al: American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol. 2010, 28: 2784-2795. 10.1200/JCO.2009.25.6529.CrossRefPubMedPubMedCentral
49.
Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, et al: American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2007, 131: 18-43.PubMed
50.
Carlson RW, Allred DC, Anderson BO, Burstein HJ, Carter WB, Edge SB, Erban JK, Farrar WB, Goldstein LJ, Gradishar WJ, Hayes DF, Hudis CA, Jahanzeb M, Kiel K, Ljung BM, Marcom PK, Mayer IA, McCormick B, Nabell LM, Pierce LJ, Reed EC, Smith ML, Somlo G, Theriault Rl, Topham NS, Ward JH, Winer EP, Wolff AC: Breast cancer: clinical practice guidelines in oncology. J Natl Comp Cancer Netw. 2009, 7: 122-192.
51.
Clegg LX, Reichman ME, Hankey BF, Miller BA, Lin YD, Johnson NJ, Schwartz SM, Bernstein L, Chen VW, Goodman MT, Gomez SL, Graff JJ, Lynch CF, Lin CC, Edwards BK: Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies. Cancer Causes Control. 2007, 18: 177-187. 10.1007/s10552-006-0089-4.CrossRefPubMed
52.
Gomez SL, Glaser SL: Misclassification of race/ethnicity in a population-based cancer registry (United States). Cancer Causes Control. 2006, 17: 771-781. 10.1007/s10552-006-0013-y.CrossRefPubMed
Metadata
Title
Occurrence of breast cancer subtypes in adolescent and young adult women
Authors
Theresa HM Keegan
Mindy C DeRouen
David J Press
Allison W Kurian
Christina A Clarke
Publication date
01-04-2012
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 2/2012
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr3156

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