Women 34 Years and Younger with Early Breast Cancer at Increased Risk for Recurrence

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According to results presented at the 45th annual meeting of the American Society for Therapeutic Radiation and Oncology, women 34 years or younger treated with breast conserving therapy for breast cancer are at an increased risk for the development of local-regional recurrences. Women in this age group should be monitored frequently to detect and treat recurrences at their earliest stage.

Approximately 250,000 women are diagnosed with breast cancer every year in the United States. The majority of women diagnosed with breast cancer are over the age of 50; however, younger women are not exempt from this disease. There have been some associations made between young age and increased aggressiveness of breast cancer, as data has indicated that younger women treated with breast-conserving therapy appear to have an increased incidence of recurrences in or near the site of origin. Breast conserving therapy refers to therapy in which only the cancer and a margin of healthy tissue are surgically removed, as opposed to the whole breast, in patients who are diagnosed with early-stage breast cancer. Radiation and/or chemotherapy usually follow breast-conserving surgery, in an attempt to kill any cancer cells that may remain in the body. Although younger age has been associated with a more aggressive course of breast cancer in many cases, researchers haven?t established what age defines ?young?.

Recently, researchers from the MD Anderson Cancer Center evaluated data involving women under the age of 40 diagnosed with breast cancer. The study involved 206 women who were treated between 1987 and 2000 with breast conserving therapy. Eighty percent of women were treated with chemotherapy and 20% with Nolvadex ® (tamoxifen). The average follow-up was over 5 years. Although several variables were assessed in an attempt to recognize an association with local-regional recurrences, including type of therapy, exact extent of cancer spread, the width of normal tissue surrounding the cancer obtained from surgery, detectability of cancer on mammography, and different age groups, women who were diagnosed with cancer at the age of 34 or younger had the highest rate of local-regional recurrences. At 5 years, the rate of local-regional recurrences occurred in 13% of women ages 34 or younger, compared to only 6% in women ages 35 or older who had matched disease characteristics. At 10 years, the risk increased further, with 29% of women 34 years or younger experiencing a local-regional recurrence, compared with only 10% of women aged 35 or older. However, survival at 5 and 10 years was 95% for both age groups.

The researchers concluded that women who are diagnosed with early breast cancer at the age of 34 or younger and undergo breast-conserving therapy are at an increased risk of developing a local-regional recurrence and should be monitored closely and frequently. Overall survival was not affected by early age of diagnosis. Patients who are 34 years or younger and have been diagnosed with breast cancer should discuss a schedule for screening for recurrences with their physician.

Reference: Bonnen M, Outlaw E, McNeese M, et al. Factors associated with breast recurrence in young females treated with breast conservation therapy: how young is young? Proceedings from the 45th annual meeting of the American Society for Therapeutic Radiology and Oncology. 2003. Abstract #2020. S356.