TNM stage at diagnosis is more predictive of prognosis than pathological complete response in young breast cancer treated with neoadjuvant chemotherapy

This study was carried out to investigate chemotherapy response and its relation with prognosis in young breast cancer patients who were treated with neoadjuvant chemotherapy (NCT). A total of 74 patients aged 35 years or less and 67 patients aged 60 years or more, who received NCT from January 2003 to December 2013, were included. Young patients presented a tendency to have a tumor size of more than 5 cm (P=0.085) and to have lymphovascular invasion (P=0.007) compared with older counterparts. Pathological complete response (PCR) rates were similar between the young group and the old cohort (12.2 vs. 13.4%, P=0.821). Patients in the younger group showed significantly lower 5-year disease-free survival compared with the old subset (62.2 vs. 77.8%, P= 0.037), but no significant difference in the 5-year overall survival was observed (84.0 vs. 94.8%, P=0.212). In the group of young patients, PCR was not a significant predictor for diseasefree survival (P= 0.408), whereas significant differences were observed with respect to the ascending TNM (tumor-node-metastasis) stage at diagnosis (P= 0.001). Young breast cancer patients treated with NCTpresent more aggressive clinicopathological features and worse prognosis compared with their elderly counterparts. TNM stage at diagnosis may be more predictive of prognosis than PCR in young breast cancer patients treated with NCT.