NEW YORK (Reuters Health) - A new study confirms that women with breast
cancer who are 35 years old or younger are more likely than older women to have
their cancer come back after treatment.
The study also shows that the likelihood of recurrence in younger breast cancer
patients is influenced by the type of treatment they received. The disease was
less apt to recur in young women who had mastectomy plus radiation than in young
women who had mastectomy alone or breast-conserving therapy.
The findings stem from a review of 652 women aged 35 or younger who were treated
for breast cancer at the University of Texas M. D. Anderson Cancer Center over
more than 30 years. In total, 197 of the women had breast-conserving therapy,
237 had mastectomy and 234 had mastectomy plus radiation.
For the group as a whole, the researchers found that the rate of relapse was
15.1 percent in women who had mastectomy plus radiation therapy, compared with
19.8 percent in women who had breast-conserving therapy and 24.1 percent for
those who had mastectomy alone.
Women with early or "stage I" breast cancer had similar outcomes with
breast-conserving therapy and mastectomy, but adding chemotherapy to either
treatment was beneficial, the researchers found. "The data support consideration
of chemotherapy for all patients (with stage I disease) until more definitive
data are gathered regarding appropriate selection criteria," they wrote in the
International Journal of Radiation Oncology, Biology, and Physics.
Women with "stage II" disease, they report, achieved the best control rates with
mastectomy plus radiation therapy.
Recurrence of breast cancer after optimal treatment in young women "remains a
significant problem," study leader Dr. Beth M. Beadle, of University of Texas M.
D. Anderson Cancer Center in Houston, said in a statement issued by the American
Society for Radiation Oncology (ASTRO).
Previous studies have shown that younger breast cancer patients consistently
have poorer outcomes than patients who develop the disease later in life. While
the reason for this is not clear, doctors suspect that breast cancer in younger
patients is more aggressive.
"Our study hopefully will help radiation oncologists plan therapies for younger
breast cancer patients, who have inferior outcomes compared to older patients,
and generate new interest in prospective studies to evaluate the best treatment
strategies for these young women," Beadle said.
SOURCE: International Journal of Radiation Oncology, Biology, and Physics, March
1, 2009.
