[MOL] BC deadlier in younger women..... [01057] Medicine On Line

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[MOL] BC deadlier in younger women.....


Breast Cancer Deadlier In Younger Women

Reuters Health
February 18, 2000

NEW YORK (Reuters Health) - All women younger than 35 years old with breast cancer should undergo chemotherapy after having surgery to remove the tumor, even when the cancer is thought to be unlikely to recur, researchers in Denmark report.

The recommendation comes from a study that found an increased risk of dying from breast cancer among young women with low risk disease who did not receive chemo after surgery.

``It has been known for some time that women diagnosed at a young age with breast cancer do worse than middle-aged women,'' one of the study's authors, Dr. Mads Melbye, of the Statens Serum Institut in Copenhagen, told Reuters Health.

``We have found that this difference in survival is not present among those who receive chemotherapy after surgical removal of their tumor,'' Melbye noted. ``It is only seen among those who do not receive chemotherapy afterwards.''

In the study, Melbye and colleagues examined the risk of dying within 10 years of being diagnosed with breast cancer in 10,356 Danish women younger than 50 years old. Most of the women in the study underwent mastectomy to remove the tumor, but some had a lumpectomy, a procedure which involves removing the tumor and some of the surrounding breast tissue.

Among women who did not have chemotherapy after surgery, the risk of dying was significantly higher in younger women, the researchers report in the February 19th issue of the British Medical Journal. Compared with women aged 45 to 49, this risk was 40% higher in women aged 35 to 39 and 118% higher in those younger than 35 years old. Among women who underwent chemotherapy, however, the survival rates in the various age groups did not differ significantly.

For some reason, breast tumors that develop at a young age appear to be more aggressive than those that occur later in life, according to the report. Based on the results of this study, chemotherapy should be considered for all young women with breast cancer, even if the cancer has not spread, according to Melbye.

``(If) we do anything to improve the survival for just some of these women, we have made a significant step forward,'' Melbye told Reuters Health.

According to Dr. Andrew Tutt and Dr. Gillian Ross, both of the Institute of Cancer Research in London, exactly why younger women with breast cancer tend not to do as well as middle-aged women remains unclear. But until the causes are better understood, it is a good idea to consider chemotherapy for all young women with breast cancer, they note in an editorial that accompanies the study. SOURCE: British Medical Journal 2000;320:474-478, 478-479.

Warmly, lillian
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