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We sought to determine whether the levels of expression of 17 candidate genes were associated with locoregional control after breast-conserving treatments of early-stage breast cancers in young, premenopausal women.    Methods  Gene expression was measured by using RT-PCR in the breast tumors of a series of 53 young (younger than 40 years), premenopausal patients. All treatments consisted of primary breast-conserving surgery followed by whole-breast radiotherapy (± regional lymph nodes) with or without systemic treatments (chemotherapy ± hormone therapy). The median follow-up was 10 years.    Results  The 10-year locoregional control rate was 70% (95% CI, 57% to 87%). In univariate analysis, no clinical/pathologic prognostic factors were found to be significantly associated with decreased locoregional control. Expression of three genes was found to be significantly associated with an increased locoregional recurrence rate: low  estrogen-receptor β , low  aromatase , and high  GATA3 . Two others were associated with only a trend ( P  < 0.10): low  HER1  and  SKP2 . In multivariate analysis, only the absence of aromatase was significantly associated with an increased locoregional recurrence rate ( P  = 0.003; relative risk = 0.49; 95% CI 0.29 to 0.82).    Conclusions  Recent data give credit to the fact that breast cancer in young women is a distinct biologic entity driven by special oncogenic pathways. Our results highlight the role of estrogen-signaling pathways (mainly  CYP19/aromatase ,  GATA3 , and  ER-β ) in the risk of locoregional recurrence of breast cancer in young women. Confirmation in larger prospective studies is needed.

Tumor aromatase expression as a prognostic factor for local control in young breast cancer patients after breast-conserving treatment