中文摘要：

目的分析中国年轻乳腺癌的临床病理特征，并探讨年轻乳腺癌患者的预后。方法回顾分析北京肿瘤医院乳腺中心1994年12月至2003年12月收治的1538例Ⅰ～Ⅲ期可手术原发性乳腺癌患者的临床资料，其中年龄≤60岁且有完整随访资料者1075例。按年龄将1075例患者分为年轻组（≤40岁，208例）和对照组（41～60岁，867例），分析两组患者的预后及临床病理特征之间的差异。结果与对照组相比，年轻组更倾向于淋巴结转移（P=0．016）、雌激素受体表达阴性（P=0．016）以及人表皮生长因子受体2表达阳性（P=0．001）。年轻组和对照组5年无病生存率（DFS）分别为73．3％和84．1％（P〈0．001），5年总生存率（OS）分别为83．5％和89．1％（P=0．004）。进一步分层分析显示，在Ⅰ-Ⅱ期患者中年轻组预后不良，而在Ⅲ期患者中年轻组预后与对照组差异无统计学意义。在Ⅰ-Ⅱ期患者中，年龄≤40岁是影响DFS（HR=1．78，95％CI：1．19—2．66；P=0．005）和OS（HR=1．71，95％CI：1．01～2．90；P=0．046）的独立不良预后因素。结论中国年轻乳腺癌患者预后不良，这种不良预后在临床Ⅰ-Ⅱ期乳腺癌患者中更为明显。

英文摘要：

Objective To analyze the clinicopathologic characteristics and evaluate the prognosis in young Chinese women with breast cancer. Methods A total of 1538 female patients with operable primary breast cancer （stage Ⅰ-Ⅱ ） treated at our hospital from December 1994 to December 2003 were analyzed retrospectively. Among them, 1075 patients （ ≤60 yrs） with the complete follow-up data were divided into two groups according to age： young breast cancer group （ ≤40 yrs, n = 208） and control group （41 -60 yrs, n = 867） to analyze the differences in their clinicopathologic characteristics and evaluate the prognosis of both groups. Results The patients with young breast cancer were more likely to have positive lymph nodes （P =0. 016）, a negative expression of ER （estrogen receptor） （P = 0. 016） and a positive expression of HER2 （P = 0. 001 ）. The 5-year disease-free survival （DFS） rates of young breast cancer group and control group were 73.3% and 84. 1% （P 〈0. 001 ） and the 5-year overall survival （OS） rates 83.5% and 89. 1% （P=0. 004） respectively. Moreover, the patients with young breast cancer had a worse DFS than control group in patients with stage Ⅰ-Ⅱ disease but not in those with stage Ⅲ disease. And ≤40 years was an independent unfavorable prognostic factor of DFS （ HR = 1.78, 95% CI： 1.19 - 2. 66, P = 0. 005 ） and OS （HR = 1.71, 95% CI： 1.01 - 2. 90, P = 0. 046 ） in the patients with stage Ⅰ-Ⅱ disease. Conclusion Chinese women with young breast cancer have a worse prognosis, particularly in those with stage Ⅰ-Ⅱ disease.