|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
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.