Should All Young Women With Breast Cancer Get Chemo?
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
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,
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
Gary Clark, PhD, professor of medicine and associate director of The Breast
Center at Baylor College of Medicine in Houston, says that the study's results
showing worse prognosis in the younger age groups is consistent with what has
been found in other studies. However, he does not think that all women with
breast cancer should be given chemotherapy based solely on age.
"The authors seem to suggest that if you give chemotherapy to this
group, it overcomes this bad prognosis and pretty much makes them equal to the
outcome of older women," he says in an interview with WebMD. "They
conclude that younger age alone should be considered a reason to use
chemotherapy. Although age is definitely one of the factors that the patient,
family, and treatment team should consider, it is not the only factor."
- When women under age 35 are diagnosed with breast cancer, they don't seem
to do as well with treatment, compared to women who are first diagnosed at an
- Researchers suggest that offering these younger breast cancer patients
chemotherapy as part of their overall treatment can help them get better
- Observers note, however, that just because a breast cancer patient is young
doesn't mean she should automatically receive chemotherapy.