Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study

PURPOSEBreast cancer is uncommon in adolescent and young adult (AYA) women, accounting for approximately 1.8% of all breast cancers. There is a risk of delayed diagnosis of breast cancer among AYA women, especially among those residing in rural areas. The aim of this study was to assess the outcomes...

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Main Authors: Erika Arnold, Devin Laubscher, Huzaifa Saeed, Osama Ahmed, Ayesha Bashir, Haji Chalchal, Gary Groot, Duc Le, Mita Manna, Pamela Meiers, Prosanta Mondal, Shahid Ahmed
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-06-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO-25-00018
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author Erika Arnold
Devin Laubscher
Huzaifa Saeed
Osama Ahmed
Ayesha Bashir
Haji Chalchal
Gary Groot
Duc Le
Mita Manna
Pamela Meiers
Prosanta Mondal
Shahid Ahmed
author_facet Erika Arnold
Devin Laubscher
Huzaifa Saeed
Osama Ahmed
Ayesha Bashir
Haji Chalchal
Gary Groot
Duc Le
Mita Manna
Pamela Meiers
Prosanta Mondal
Shahid Ahmed
author_sort Erika Arnold
collection DOAJ
description PURPOSEBreast cancer is uncommon in adolescent and young adult (AYA) women, accounting for approximately 1.8% of all breast cancers. There is a risk of delayed diagnosis of breast cancer among AYA women, especially among those residing in rural areas. The aim of this study was to assess the outcomes of AYA women for breast cancer in relation to rural residence.METHODSThis cohort study evaluated all women aged 35 years and younger with histologically confirmed breast cancer diagnosed between 2000 and 2019 in a Canadian province. A multivariate Cox proportional hazards model was used to assess the prognostic significance of rural residence and other variables for overall survival (OS) across all stages and disease-free survival in early-stage breast cancer.RESULTSA total of 248 eligible AYA women with a median age of 32 years were identified, of whom 24% were younger than 30 years. Of all patients, 51% had node-positive disease, and 11% had stage IV disease at diagnosis. Among those with invasive breast cancer, 45% had hormone receptor–positive and human epidermal growth factor receptor 2 (HER2)-negative disease; 30% had HER2-positive disease; and 25% had triple-negative breast cancer (TNBC). There were 53% rural and 47% urban residents. In multivariate analysis for OS for stage 0 to IV disease, rural residence (hazard ratio [HR], 1.75 [95% CI, 1.08 to 2.81]), TNBC (HR, 2.25 [95% CI, 1.34 to 3.80]), and stage IV disease (HR, 8.1 [95% CI, 4.72 to 13.94]) were associated with inferior OS.CONCLUSIONAYA women with breast cancer have a high incidence of node-positive disease and aggressive subtypes. This study found a significant association between rural residence and OS. These findings emphasize the need for enhanced early detection and personalized treatment strategies, particularly for rural patients and those with TNBC.
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spelling doaj-art-130de49d249048fbb3f2f4fe5698cfb62025-08-20T03:47:12ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-06-011110.1200/GO-25-00018Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort StudyErika Arnold0Devin Laubscher1Huzaifa Saeed2Osama Ahmed3Ayesha Bashir4Haji Chalchal5Gary Groot6Duc Le7Mita Manna8Pamela Meiers9Prosanta Mondal10Shahid Ahmed11McGill University, Montreal, QC, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaClinical Research Support Unit, University of Saskatchewan, Saskatoon, SK, CanadaCollege of Medicine, University of Saskatchewan, Saskatoon, SK, CanadaPURPOSEBreast cancer is uncommon in adolescent and young adult (AYA) women, accounting for approximately 1.8% of all breast cancers. There is a risk of delayed diagnosis of breast cancer among AYA women, especially among those residing in rural areas. The aim of this study was to assess the outcomes of AYA women for breast cancer in relation to rural residence.METHODSThis cohort study evaluated all women aged 35 years and younger with histologically confirmed breast cancer diagnosed between 2000 and 2019 in a Canadian province. A multivariate Cox proportional hazards model was used to assess the prognostic significance of rural residence and other variables for overall survival (OS) across all stages and disease-free survival in early-stage breast cancer.RESULTSA total of 248 eligible AYA women with a median age of 32 years were identified, of whom 24% were younger than 30 years. Of all patients, 51% had node-positive disease, and 11% had stage IV disease at diagnosis. Among those with invasive breast cancer, 45% had hormone receptor–positive and human epidermal growth factor receptor 2 (HER2)-negative disease; 30% had HER2-positive disease; and 25% had triple-negative breast cancer (TNBC). There were 53% rural and 47% urban residents. In multivariate analysis for OS for stage 0 to IV disease, rural residence (hazard ratio [HR], 1.75 [95% CI, 1.08 to 2.81]), TNBC (HR, 2.25 [95% CI, 1.34 to 3.80]), and stage IV disease (HR, 8.1 [95% CI, 4.72 to 13.94]) were associated with inferior OS.CONCLUSIONAYA women with breast cancer have a high incidence of node-positive disease and aggressive subtypes. This study found a significant association between rural residence and OS. These findings emphasize the need for enhanced early detection and personalized treatment strategies, particularly for rural patients and those with TNBC.https://ascopubs.org/doi/10.1200/GO-25-00018
spellingShingle Erika Arnold
Devin Laubscher
Huzaifa Saeed
Osama Ahmed
Ayesha Bashir
Haji Chalchal
Gary Groot
Duc Le
Mita Manna
Pamela Meiers
Prosanta Mondal
Shahid Ahmed
Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
JCO Global Oncology
title Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
title_full Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
title_fullStr Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
title_full_unstemmed Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
title_short Outcomes of Adolescent and Young Adult Women With Breast Cancer in Rural and Urban Saskatchewan: A Retrospective Cohort Study
title_sort outcomes of adolescent and young adult women with breast cancer in rural and urban saskatchewan a retrospective cohort study
url https://ascopubs.org/doi/10.1200/GO-25-00018
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