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The Impact of Young Age on Breast Cancer Prognosis: A Systematic Review and Meta-Analysis

Yongxin Li1, Yuanfang Xin2, Chengrong Zhang1

  • 1Breast Disease Diagnosis and Treatment Center of Affiliated Hospital of Qinghai, University & Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China.

Current Cancer Drug Targets
|October 1, 2025
PubMed

Insights

Young breast cancer patients face poorer survival outcomes, including overall survival and disease-free survival, compared to older patients. Despite higher pathological complete response rates, young women experience worse prognoses, highlighting the need for tailored care.

Area of Science:

  • Oncology
  • Epidemiology

Background:

  • Lack of consensus exists regarding the prognostic impact of young age (≤35 or 40 years) on breast cancer outcomes.
  • Young breast cancer (YBC) represents a distinct clinical challenge with potentially different prognostic trajectories.

Purpose of the Study:

  • To conduct a comprehensive meta-analysis evaluating the survival prognosis of young breast cancer patients compared to non-young counterparts.
  • To identify specific survival outcomes and pathological response rates associated with YBC.

Main Methods:

  • A systematic literature search was performed across major databases (PubMed, Embase, Web of Science, Cochrane) and conference proceedings up to July 2023.
  • Included studies reported hazard ratios (HRs) with 95% confidence intervals (CIs) or Kaplan-Meier curves for outcomes like overall survival (OS), disease-free survival (DFS), and pathological complete response (pCR).
  • The meta-analysis was registered with PROSPERO (CRD42023459282).

Main Results:

  • This meta-analysis of 129 studies (approx. 1,065,000 patients) revealed significantly worse OS, DFS, breast cancer-specific survival (BCSS), local recurrence-free survival (LRFS), distant disease-free survival (DDFS), and progression-free survival (PFS) in YBC patients.
  • YBC patients demonstrated higher pathological complete response (pCR) rates compared to non-young breast cancer (NYBC) patients.
  • Subgroup analyses indicated prognostic variations based on molecular subtype, geographic region, and disease stage.

Conclusions:

  • Young breast cancer patients exhibit inferior survival outcomes compared to older patients, despite achieving higher pCR rates.
  • Prognosis in YBC is influenced by critical factors including molecular subtype, stage, and patient's region.
  • Findings emphasize the necessity for early screening, enhanced patient education, and individualized treatment strategies for YBC.
Abstract

Keywords:
Young patients with breast cancerbreast cancerprognoses.survival

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