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Should All Young Women With Breast Cancer Get Chemo?

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Feb. 18, 2000 (Indianapolis) -- Women diagnosed with breast cancer in their 20s and 30s seem to have a poorer prognosis than those who are first diagnosed in middle age. Results of a large, retrospective study from Denmark published in the Feb. 19 issue of the British Medical Journal suggest that all women under the age of 35 with breast cancer should be offered chemotherapy following surgery.

Denmark, with its decades-old comprehensive health registries, offered a unique opportunity for the researchers to study the relationship between age and breast cancer survival rates. "We wanted to see how stage of disease at time of diagnosis and treatment influenced the negative effect of young age on the survival of these women," Mads Melbye, a professor in the department of epidemiology research at the Danish Epidemiology Science Center in Copenhagen, tells WebMD.

The group looked at more than 10,000 women with primary breast cancer who were less than 50 years old at diagnosis. Detailed information on tumor characteristics, treatment regimens and survival were available from a database maintained by the Danish Breast Cancer Cooperative Group. Researchers measured the relative risk of dying within the first 10 years after diagnosis.

Overall, young women -- those under 35 years of age at diagnosis -- who did not receive chemotherapy had a significantly increased risk of dying. These women also were twice as likely to die during the 10-year period when compared to those who were diagnosed between ages 45 and 49. However, this extra risk disappeared almost entirely when those under 35 were given chemotherapy.

"Clearly, young women with what in the first place looks like a low-risk tumor, small in size and with no spread to lymph nodes, should be considered for treatment with chemotherapy," says Melbye. "That might very well eliminate the negative effect on survival observed among young women below 35 years. Young women are also young mothers and for this group of women, time is probably more precious than for any other group. Therefore, anything we can do to improve the survival for just some of these women is a significant step forward."

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