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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EEvidence suggests that breast cancer in younger women may be clinically and etiologically distinct from older women [Bleyer A et al. \u003Cem\u003ENat Rev Cancer\u003C\/em\u003E 2010]. Breast cancer in young women demonstrates a worse prognosis and a more aggressive phenotype, higher proportions of high-grade and later-stage tumors, lower estrogen receptor positivity, and, in some studies, higher expression of human epidermal growth factor receptor 2 [Bleyer A et al. \u003Cem\u003ENat Rev Cancer\u003C\/em\u003E 2010; Gnerlich JL et al. \u003Cem\u003EJ Am Coll Surg\u003C\/em\u003E 2009]. This article presents data on the response to neoadjuvant chemotherapy in women with breast cancer who are aged =35 years compared with older women.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EOncology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EBreast Cancer\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EAdjuvant\/Neoadjuvant Therapy\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EEvidence suggests that breast cancer in younger women may be clinically and etiologically distinct from older women [Bleyer A et al. \u003Cem\u003ENat Rev Cancer\u003C\/em\u003E 2010]. Breast cancer in young women demonstrates a worse prognosis and a more aggressive phenotype, higher proportions of high-grade and later-stage tumors, lower estrogen receptor (ER) positivity, and, in some studies, higher expression of human epidermal growth factor receptor 2 (HER2) [Bleyer A et al. \u003Cem\u003ENat Rev Cancer\u003C\/em\u003E 2010; Gnerlich JL et al. \u003Cem\u003EJ Am Coll Surg\u003C\/em\u003E 2009]. While some studies point to a unique breast cancer biology in young women, others have illustrated that the aggressive nature is the result of higher frequencies of aggressive breast cancer subtypes among younger patients. Sibylle Loibl, MD, PhD, German Breast Group, Neu-Isenburg, Germany, presented data on the response to neoadjuvant chemotherapy in women with breast cancer who are aged \u226435 years compared with older women.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe meta-analysis included 8949 patients with operable or locally advanced nonmetastatic breast cancer from 8 neoadjuvant German studies with follow-up. Patients were categorized into 3 age groups: \u226435 (n=704), 36 to 50 (n=4167), and \u226551 years (n=4078). All patients with endocrine responsive disease received adjuvant endocrine therapy. Subgroup analyses were conducted defined by hormone receptor (HR) and HER2 status.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EBreast cancer subtype distribution was found to differ according to patient age group. Triple-negative breast cancer (TNBC) was more common in patients aged \u226435 than patients aged \u0026gt;35 years (26% vs 19%). In contrast, HR-positive\/HER2-negative breast cancer was more common in patients aged \u0026gt;35 years compared with patients aged \u226435 years (37% vs 29%). HER2-positive tumors were similar in both age groups regardless of HR status.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe overall pathologic complete response (pCR) rate (defined as ypT0, ypN0) was significantly higher in patients aged \u226435 compared with patients aged \u226551 years (23% vs 13%; p=0.002; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). The only subgroups with pCR rates that were statistically higher for patients aged \u226435 years compared with patients aged \u226551 years were HR-positive\/HER2-negative (11% vs 6%; p=0.013) and TNBC (45% vs 25%; p=0.004).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/20\/13\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022pCR Rates Overall and in Subgroups.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1174339235\u0022 data-figure-caption=\u0022pCR Rates Overall and in Subgroups.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/20\/13\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/20\/13\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/12\/20\/13\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/14527\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EpCR Rates Overall and in Subgroups.\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003E*HR and HER2-status not available for all patients. HER2=human epidermal growth factor receptor 2; HR=hormone receptor; TNBC=triple-negative breast cancer.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from S Loibl, MD, PhD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EThe pCR rate was an independent predictor of disease-free survival (DFS) when the analysis was adjusted for age, tumor size, nodal status, histological type, grading, and clinical trial. DFS was significantly inferior in patients aged \u226435 compared with patients in the 36 to 50 (p=0.031) and the \u226551 year age groups (p=0.022). The difference was greater between age groups in patients who did not achieve pCR; patients aged \u226435 years had a 25% higher risk of relapse compared with the 36 to 50 (p=0.002) and \u226551 year age groups (p=0.001). In contrast to previous studies, patients aged \u226435 years with HR-positive\/HER2-negative breast cancer who achieved a pCR had a better DFS compared with patients in the same age group who did not achieve pCR. Local recurrence-free survival was also significantly inferior in patients aged \u226435 years compared with patients in the 36 to 50 (p=0.017) and \u226551 years age groups (p=0.00018). Overall survival was not significantly different between the 3 age groups.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThese results are retrospective and provided support to the hypothesis that breast cancer might be biologically different in very young women and the higher likelihood of achieving a pCR in young patients is driven mainly by TNBC subgroup.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/20\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzo4o1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzo4o1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}