Background Pretreatment endocrine symptoms in premenopausal patients might be considered as a potential marker of poor prognosis. We conducted a cohort study to evaluate the association between endocrine symptoms prior to treatment and recurrence-free survival (RFS) among premenopausal patients with breast cancer aged ⩽40 years. Methods Data were obtained from a prospective cohort study (NCT03131089) conducted at the Samsung Medical Center from 2013 to 2021. We included patients aged ⩽40 years who had been diagnosed with breast cancer. The primary outcome measure was RFS. Endocrine symptoms were measured using the Functional Assessment of Cancer Therapy - Endocrine Symptoms (FACT-ES). We also calculated the hazard ratio (HR) for recurrence or all-cause mortality by comparing the tertiles of the FACT-ES score at diagnosis. Results Among the 977 participants, the mean (standard deviation) age was 35.3 (3.9) years. At diagnosis, 17.2% of the patients had at least one severe endocrine symptom. During 3512 person-years of follow-up, the high symptom group had a worse RFS than the low-symptom group [HR = 2.05; 95% confidence interval (CI) = 1.19-3.54]. In particular, hot flashes (HR = 5.59; 95% CI = 1.96-15.93) and breast sensitivity (HR = 1.82; 95% CI = 1.00-3.32) were associated with reduced RFS. Conclusion Close monitoring of pretreatment endocrine symptoms may be important in patients diagnosed with breast cancer at a young age.

中文翻译：

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年轻绝经前乳腺癌患者治疗前内分泌症状和无复发生存率：一项前瞻性队列研究。

背景 绝经前患者的治疗前内分泌症状可能被认为是预后不良的潜在标志。我们进行了一项队列研究，以评估 40 岁以下绝经前乳腺癌患者治疗前内分泌症状与无复发生存期 (RFS) 之间的关联。方法数据取自 2013 年至 2021 年在三星医疗中心进行的一项前瞻性队列研究 (NCT03131089)。我们纳入了年龄≤40 岁的乳腺癌患者。主要结果指标是 RFS。使用癌症治疗功能评估 - 内分泌症状 (FACT-ES) 测量内分泌症状。我们还通过比较诊断时 FACT-ES 评分的三分位数，计算了复发或全因死亡率的风险比 (HR)。结果 977 名参与者中，平均（标准差）年龄为 35.3（3.9）岁。诊断时，17.2%的患者有至少一种严重的内分泌症状。在 3512 人年的随访中，高症状组的 RFS 比低症状组差 [HR = 2.05；95% 置信区间 (CI) = 1.19-3.54]。特别是，潮热（HR = 5.59；95% CI = 1.96-15.93）和乳房敏感性（HR = 1.82；95% CI = 1.00-3.32）与 RFS 降低相关。结论 密切监测治疗前内分泌症状对于年轻时诊断出乳腺癌的患者可能很重要。