Objective:

To assess age-related breast cancer prognosis before the expansion of Luxembourg's screening program.

Approach:

Key Findings:

• Younger patients (<40 years) had higher rates of triple-negative tumors (24%, P<0.001) and chemotherapy use (78%).
• Five-year overall survival rates were highest in women aged 40–49 (95.3%, P<0.001) and 50–69 (92.3%), lower in those <40 (91.0%), and lowest in women ≥70 (65.4%, P<0.001).
• Advanced stage (hazard ratio [HR]=2.92, 95% confidence interval [CI]: 2.05–4.17) and triple-negative subtype (HR = 2.39, 95% CI: 1.69-3.38) were linked to worse prognosis.
• Mastectomy (HR = 2.04) and absence of surgery (HR = 8.58) were associated with poorer survival.

Interpretation:

Age at diagnosis influences breast cancer prognosis through distinct tumor characteristics, impacting treatment and survival outcomes.

Limitations:

• Findings may reflect competing causes of mortality in older patients rather than breast cancer prognosis alone.
• The study is retrospective and may be subject to biases inherent in such designs.

Conclusion:

Age-specific strategies are needed for breast cancer management, particularly in light of the recent expansion of the screening program.

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