Age has a U-shaped relationship with breast cancer outcomes in women: a cohort study

Yujie Xie; Yongqing Deng; Suosu Wei; Zhen Huang; Lihui Li; Kai Huang; Chunyu Wei; Jinan Xu; Lingguang Dong; Qiuhuan Zhang; Jiehua Zhao; Quanqing Zou; Jianrong Yang

doi:10.3389/fonc.2023.1265304

Age has a U-shaped relationship with breast cancer outcomes in women: a cohort study

Front Oncol. 2023 Oct 4:13:1265304. doi: 10.3389/fonc.2023.1265304. eCollection 2023.

Authors

Yujie Xie¹, Yongqing Deng², Suosu Wei³, Zhen Huang¹, Lihui Li¹, Kai Huang¹, Chunyu Wei¹, Jinan Xu¹, Lingguang Dong¹, Qiuhuan Zhang⁴, Jiehua Zhao¹, Quanqing Zou¹, Jianrong Yang¹

Affiliations

¹ Department of Breast and Thyroid Surgery, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
² The Family Planning Office of Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
³ Department of Scientific Cooperation of Guangxi Academy of Medical Sciences, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.
⁴ Department of Colorectal and Anal Surgery, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China.

Abstract

Background and objectives: Age is a significant determinant of susceptibility to breast cancer. Currently, the available evidence regarding the non-linear correlation between the age of diagnosis and the prognosis of breast cancer patients is contradictory. Insufficient data currently exist regarding the influence of age at diagnosis on the prognosis of breast cancer. The objective of our investigation was to examine the relationship between age at diagnosis and overall survival (OS), breast cancer-specific survival (BCSS), and disease-free survival (DFS).

Methods: This retrospective cohort study included 1054 patients diagnosed with breast cancer between March 7, 2013 and December 31, 2019. The hazard ratios (HRs) and 95% confidence interval (CI) for OS, BCSS, DFS were assessed using Cox proportional hazard ratio models and restricted cubic splines (RCS).

Results: The study included 1054 breast cancer patients who met the criteria. With a median follow-up of 4.86 years, 71 patients (6.74%) died and 144 patients (13.66%) relapsed. After multivariable adjustment, age showed a U-shaped association with OS, BCSS, and DFS, with significantly higher risk at two ends, with age inflection points of 44, 44, and 41 years for OS, BCSS, and DFS, respectively. For OS, Quartile 1 (HR, 2.09; 95% CI: 0.90-4.84), Quartile 3 (HR, 2.44; 95% CI: 1.05-5.65) and Quartile 4 (HR, 3.38; 95% CI: 1.51-7.54) had poorer OS compared with Quartile 2. Similar results were found for BCSS and DFS.

Conclusions: This study confirmed a U-shaped association between age at diagnosis and breast cancer outcome.

Keywords: age; breast cancer; breast cancer-specific survival; disease-free survival; overall survival; prognosis.

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Major Project of Science and Technology of Guangxi Zhuang Autonomous Region (grant number: Guike-AA22096018) and the Specific Research Project of Guangxi for Research Bases and Talents (grant number: Guike-AD21220042).