Abstract:
Background: Breast cancer is uncommon in young women and induces more aggressive biologic characteristics.
Survival in young women has been widely studied in developed countries. Less favorable prognosis and low
survival were found.
In Morocco, this study is the first investigation of clinical features, treatment and prognosis associated with breast
cancer in young women.
Findings: Four hundred and nine women aged 35 years or less were included in this study. All these women were
diagnosed as having breast cancer at the National Institute of Oncology in Rabat, Morocco between 2003 and
2007. The relation between clinical and therapeutic characteristics and event-free survival (EFS) and overall survival
(OS) were assessed by Cox regression analysis.
The median age of the patients was 32 years. Fifty three patients (13%) have metastatic disease at diagnosis and
356 patients (87%) had localised disease. In 57.9% of the cases, the estrogen receptors status was positive. The
median follow-up was 32.2 months. After 3 years the survival rate was 80.6%. In the case of localised disease, OS
and EFS at 3 years were 83.2% and 62.5%, respectively. OS and EFS at 3 years was higher in patients with stage I
than patients with stage II and stage III (p = 0.001). Positive estrogen receptors was significantly associated to OS
and EFS at 3 years compared to negative estrogen receptors (p = 0.001). Adjuvant chemotherapy, adjuvant radio-
therapy and adjuvant hormone therapy were associated with net benefit in OS and EFS at 3 years. Cox regression
analysis showed that negative ER was significantly associated with poorer OS (HR = 2.42, 95% CI = 1.25 - 4.66,
p < 0.009) and poorer EFS (HR = 1.73, 95%CI = 1.05 - 2.86, p = 0.03). Stage III disease were associated to poorer
EFS (HR = 5.35, 95%CI = 1.60 -17.84, p = 0.006).
Conclusions: In Morocco, young women with breast cancer had less favorable prognosis. Multivariate analysis
showed that negative hormone receptor status was associated with lower EFS and OS. Clinical trials should be
launched to improve the survival of these young women with breast cancer.