Nutriovia

The incidence of breast cancer in women aged 20 to 49 have increased in the past 20 years in most racial and ethnic groups, but few studies have examined mortality data for patients in this age group, according to Adetunji Toriola, MD, PHD, MPH, Professor in the Department of Surgery and Division of Public Health and Center for Washington University School of Medicine.

“Understanding recent mortality trends will allow us to assess progress over the years and inform where to direct resources to reduce the burden of cancer in this age group,” said Toriola, who presented the study.

Toriola and her colleagues analyzed data from the Seer 17 program register, which included data on 11,661 breast cancer deaths among women aged 20 to 49 between 2010 and 2020. Using annual changes for percentage (APC). In addition, they carried out relative survival analyzes by examining the 10-year survival rate for each group and subtype.

In all the subtypes and racial / ethnic groups, the mortality based on the incidence increased from 9.70 per 100,000 women in 2010 to 1.47 / 100,000 in 2020. Luminal A had the most pronounced decline among the four subtypes, with a decline throughout the period and the greatest drop in 2017 (-32.88% APC). Triple negative breast cancer has followed a similar trend, 2018 marking its largest drop (-32.82% APC).

Even if the drop in mortality based on the incidence was the most important for the Global Luminal, survival relating to 10 years for women with this breast cancer subtype varied according to age. Among women aged 40 to 49, Luminal had the highest survival at 10 years, while among women aged 20 to 39 years, Luminal A (78.3%) had 10 years lower than Luminal B (84.2%).

“This was unexpected because the Luminal A is generally the least aggressive subtype with the most favorable prognosis,” said Toriola. “This requires confirmation in other studies, but may suggest that luminal tumors A in women aged 20 to 39 can represent a more biologically heterogeneous and potentially aggressive subgroup.”

Although mortality based on incidence has decreased for each of the racial / ethnic groups, non -Hispanic black women had mortality based on the highest incidence in 2010 (16.56 / 100,000) and in 2020 (3.41 / 100,000) and non -Hispanic white women had mortality with the lowest incidence in 2010 (9.18 / 100,000) and 2020 (1.16 / 100,000). The decreases became the most pronounced for non-Hispanic black women in 2016 (-24.15% APC), for non-Hispanic Asian / islanders of the Pacific in 2013 (-18.46% APC), for Hispanic women in 2017 (-30.15% APC) and for American and non-Hispanic Indian natives in 2018 (-47.97% APC).

The 10 -year survival analysis revealed that non -Hispanic black women had the worst survival results, while non -Hispanic white women and non -Hispanic Asian / peaceful women had the best.

“We have made enormous progress in reducing the mortality of breast cancer in young women, but there are still possibilities for improvements, in particular with regard to the elimination of disparities,” said Toriola.

Toriola explained that the most drastic decreases observed after 2016 probably reflect the progress of treatment options, the greatest absorption of precision medicine and expanded access to care and screening in women aged 40 to 49. For example, he mentioned how the wider adoption of CDK4 / 6 inhibitors and optimization of endocrine therapy, which began to receive approval from the FDA and clinical adoption between 2015 and 2016, has probably played key roles in improving mortality rates for negative her2 cancers for hormian receptors – including the light AA

“We must continue to carry out hard -working research to ensure an additional reduction in breast cancer mortality, including research on understanding tumor biology and molecular mechanisms stimulating cancerogenesis and response to treatment in younger women,” said Toriola. “In addition, we must encourage and give access to population -based screening among women aged 40 to 49 and targeted screening in younger women at high risk, and plead for access to high -quality treatment and care for all women.”

The main limits of this study include monitoring time limited to 10 years and a relatively smaller number of breast cancer deaths in certain racial / ethnic groups.

The funding of this study was provided by the Washington University School of Medicine. Toriola does not declare any conflict of interest.