Thursday, February 28, 2013

Breast Cancer Rates Increase Among Young Women

here has been a small increase in the incidence of advanced stage breast cancer among women 25 to 39 years old, according to a recent study in JAMA.

Breast cancer is the most common form of malignant tumor in women aged 15 to 39 and accounts for nearly 14% of all cancer cases in men and women in that age group. The risk of a woman developing breast cancer before the age of 40 is 1 in 173, according to a 2008 study.

The authors wrote:

"Young women with breast cancer tend to experience more aggressive disease than older women and have lower survival rates. Given the effect of the disease in young people and a clinical impression that more young women are being diagnosed with advanced disease, we reviewed the national trends in breast cancer incidence in the United States."

The study involved assessing three U.S. National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registries from 1973-2009, 1992-2009 and 2000-2009. Rebecca H. Johnson, M.D., the leader of the study, and her colleagues obtained information from the registries regarding the incidence of breast cancer, any incidence trends, the survival rate as a function of age, and the extent of the cancer at diagnosis.

The SEER defines localized breast cancer as cancer only found in the breast, regional cancer as cancer that's spread to adjacent organs such as the chest well, and distant cancer as cancer that's spread from one part of the body to another part not directly related to it (in this case the brain and lungs would be an example).

Over the past three to four decades, the incidence of distant breast cancer in young women aged 25 to 39 has gone up steadily, from a rate of 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009. This difference translates to an annual increase in incidence of 2.07 percent per year.

The authors added:

"The trajectory of the incidence trend predicts that an increasing number of young women in the United States will present with metastatic breast cancer in an age group that already has the worst prognosis, no recommended routine screening practice, the least health insurance, and the most potential years of life."

The increasing incidence of distant cancer was greatest among women aged 25 to 34 and got progressively smaller in women as they got older, by 5-year age intervals. There was no real increase in the incidence of distant breast cancer in women 55 years old or above. The authors added that: "For young women aged 25 to 39 years, the incidence of distant disease increased in all races/ethnicities assessed since at least 1992, when race/ethnicity became available in the SEER database."

This finding is particularly concerning, considering that young women, between 20 to 34 years of age who develop breast cancer, have the lowest 5-year breast cancer survival rate as a function of age.

Researchers from the Institut Jules Bordet, in Brussels, Belgium, identified that breast cancer in young women is in itself a biologically unique disease, requiring customized management strategies, and is associated with age related biological processes that are independent from other, more common factors, used in prognosis by oncologists.

Young women who are diagnosed with breast cancer often find themselves feeling isolated and alone, given that most medical resources for the disease are designed for women over 50. In addition, a study in the Journal of National Cancer Institute revealed that health-related quality of life is a lot lower in young women with breast cancer - it is linked with weight gain, increased psychological distress and early onset of menopause.

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