Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland

Article Article scientifique Article Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland eng 2022-03-04 2022-03-04 author Montagna Giacomo 0000-0003-3511-369X author Schaffar Robin 673899 author Bordoni Andrea author Spitale Alessandra author Terribile Daniela A. author Rossi Lorenzo author Bergeron Yvan author van der Linden Bernadette W. A. 0000-0002-4815-2121 author Konzelmann Isabelle author Rohrmann Sabine author Staehelin Katharina author Maspoli-Conconi Manuela author Bulliard Jean-Luc 0000-0001-9750-2709 author Meani Francesco author Pagani Santoro Olivia 878467 author Rapiti Aylward Elisabetta 134294 1328 10.3390/cancers14051328 35267635 2072-6694 PMC8909610 https://www.mdpi.com/2072-6694/14/5/1328 Background: An increase in breast cancer (BC) incidence in young women (YW) as well as disparities in BC outcomes have been reported in Switzerland. We sought to evaluate treatment and outcome differences among YW with BC (YWBC). Methods: YW diagnosed with stage I-III BC between 2000-2014 were identified through nine cancer registries. Concordance with international guidelines was assessed for 12 items covering clinical/surgical management, combined in a quality-of-care score. We compared score and survival outcome between the two linguistic-geographic regions of Switzerland (Swiss-Latin and Swiss-German) and evaluated the impact of quality-of-care on survival. Results: A total of 2477 women were included. The median age was 37.3 years (IQR 34.0-39.4 years), with 50.3% having stage II BC and 70.3% having estrogen receptor positive tumors. The mean quality-of-care score was higher in the Latin region compared to the German region (86.0% vs. 83.2%, p < 0.0005). Similarly, 5- and 10-year overall survival rates were higher in the Latin compared to the German region (92.3% vs. 90.2%, p = 0.0593, and 84.3% vs. 81.5%, p = 0.0025, respectively). There was no difference in survival according to the score. In the univariate analysis, women in the Latin region had a 28% lower mortality risk compared to women in the German region (hazard ratio 0.72; 95% CI 0.59-0.89). In the multivariable analysis, only stage, differentiation, tumor subtype and treatment period remained independently associated with survival. Conclusions: We identified geographic disparities in the treatment and outcome of YWBC in Switzerland. National guidelines for YWBC should be implemented to standardize treatment. Awareness should be raised among YW and clinicians that BC does not discriminate by age. Switzerland Breast cancer Management Outcome Young women Dewey 613 Dewey 616 Swiss Cancer League HSR-4078-11-2016 215 Registre genevois des tumeurs 22A12 56 Département de médecine 221 false 1311 Epidémiologie des tumeurs 1017 Cancers 14 5 3bb32079-71fd-432f-a0d2-978625de271a Article (Published version) Public Article-scientifique-from-unpaywall.pdf 800065 application/pdf CC BY-4.0 43e29a7c-691e-4612-b677-67144f5b875c Appendix Public cancers-1583503-supplementary.pdf 233034 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale / Registre genevois des tumeurs Faculté de médecine / Section de médecine clinique / Département de médecine

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Management and Outcome of Young Women (≤40 Years) with Breast Cancer in Switzerland	Cancers			2022	298	317

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Pagani Santoro, Olivia