Predict score and luminal localized breast cancer in young women

Breast cancer is diagnosed in young women in 8% of cases. The aim of this study was to assess the Predict score in case of luminal localized breast cancer in young women.

This is a retrospective study carried out over 10 years (January 2008-December 2017) in the medical oncology department at Habib Bourguiba hospital in Sfax. We included young patients under 35 years with histologically localized breast cancer with positive hormone receptors and negative HER2 status. We used the Predict score (available at https://breast.predict.nhs.uk/) to determine the overall survival benefit of chemotherapy and hormone therapy at 10 years.

We collected 31 patients with a mean age of 31.4 years. The mean tumor size was 49.7 mm. Fifty-four percent of the patients had tumors classified as T3-T4 or N2-N3. Thirty-five percent of cases were luminal A, 58% of which had stage T1-T2 or N0-N1. SBR II and SBR III grade were identified in 67% and 33% respectively. Twenty-eight patients had received both hormone therapy and chemotherapy. 3 patients received hormone therapy alone. The 10-year overall survival was 51.9%. The overall survival calculated by the Predict score at 10 years was 63.9%. There was a significant difference between the real overall survival at 10 years and that calculated by the Predict (p = 0.001). The subgroup analysis showed that the OS was significantly better for the Luminal A versus B phenotype (p = 0.019).

The Predict score overestimated the 10-year overall survival by 12% in the global study. In our study, the predict score seems to be of a low interest in case of young women (under 35 years) with localized luminal breast. This may be explained by the importance of young age as a poor prognostic factor.