Breast cancer among young women increasing
rate of advanced breast cancer for U.S. women 25 to 39 years old nearly
doubled from 1976 to 2009, a difference too great to be a matter of
chance, a study finds.
February 26, 2013|By Monte Morin, Los Angeles Times
Dr. Rebecca Johnson, who was diagnosed with breast cancer when she was 27,… (Elaine Thompson, Associated…)
Johnson was 27 years old and had just graduated from medical school
when she got the diagnosis: breast cancer. She thought she was a rare
case, but then a few of her friends got it too. So did some friends of
Was it all just a coincidence, or was breast cancer becoming more common in younger women?
really wondered," said Johnson, now 44 and the director of the
Adolescent and Young Adult Oncology program at Seattle Children's
Hospital. So she examined decades' worth of data from the National
Cancer Institute and made a disturbing find: Cases of younger women with
advanced breast cancer have increased about 2% each year since the
mid-1970s and show no signs of abating.
The results, published in
Wednesday's edition of the Journal of the American Medical Assn.,
confirmed the suspicions of many oncologists who had noticed an uptick
in patients younger than 40 with cancer that had spread to the bones,
brain or lungs.
In 1976, 1.53 out of every 100,000 American women
25 to 39 years old was diagnosed with advanced breast cancer, the study
found. By 2009, the rate had almost doubled to 2.9 per 100,000 women in
that age group — a difference too large to be a chance result.
studies have failed to show an absolute increase," said Dr. Benjamin
Paz, a City of Hope Cancer Center surgeon who was not involved in the
study. "Now, looking at a longer period of time, this study shows
there's clearly been an increase. It's the first to do so."
trend, which has yet to be explained, has raised real concerns about
future efforts to treat the disease. Survival rates for young women with
metastatic breast cancer are much lower than they are for older women,
because the cancer tends to behave more aggressively in the young.
data from the U.S. Surveillance, Epidemiology and End Results, or SEER,
database detected a significant increase among black and white women in
both urban and non-urban areas, suggesting that the root cause or
causes were widespread.
"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," Johnson and her coauthors wrote.
To be sure, it
remains uncommon for a young woman to be diagnosed with breast cancer.
About 7% of all breast cancers diagnosed in the United States involve
women younger than 40, and on average, 1 in 173 women in this age group
risks developing some type of breast cancer.
Johnson and her
coauthors said they hoped that other Western nations would corroborate
their findings using their own data. If a trend is established, research
should investigate the reason for the increase, they added.
hypothesized that the trend was due to a variety of lifestyle changes
that have occurred during the study period. Diet, exercise, obesity,
earlier onset of menstruation, use of birth control, delayed pregnancy
and other factors all might play a role.
few smaller studies have examined risk factors such as obesity,
sedentary lifestyle and high caloric intake and concluded that when
combined, they do predispose to young adult breast cancer.
it is still unknown exactly why cancers can behave so much more
aggressively in younger patients, and why estrogen — or the blocking of
it — has a very different effect on cancer cells in younger and older
"There's something different about breast cancers in young
adults than in older people," Johnson said. "Researchers that are
focusing on cancer in young adults are trying to tease out what those
biological differences are."
In the meantime, she said she hoped the study would alert young women to the risks of breast cancer.
no evidence that 29-year-olds should go out and get mammograms or
anything like that," Johnson said. "But if there's a take-home message, I
would say that it would be awareness of the fact that breast cancer can
happen even in young women and that it's important for both young women
and their doctors to be aware of this."
Edited by Finesseful - Feb 28 2013 at 4:51pm