A new study by a team of British researchers has focused on an often overlooked demographic of breast cancer patients-those who catch the disease in their early 20s.

Writing in the journal Cancer, Dr. Ashutosh Kothari of Guy's Hospital in London and colleagues noted that breast cancer is rare among young women; about 1 percent of women in their 20s will develop the disease. For this reason, most researchers have focused on middle age and older women for testing optimal treatment strategies. This is alarming, Kothari contends, because the disease may be more aggressive in younger women and thus necessitate different treatment strategies than would normally be recommended for older women.

Kothari's team evaluated the records of 15 breast cancer patients who were 25 years old or younger when they were first diagnosed. They compared these records with those of 45 women who were diagnosed with breast cancer between the ages of 26 and 35.

Among the patients age 25 and younger, 13 were diagnosed with invasive breast cancer and 4 had cancer that had spread to the lymph nodes; 9 of the patients with invasive breast cancer experienced recurrence and died.

The researchers found that the survival rates among the very young women were no different than those seen for the 26 to 35 year old group. However, when they compared both of these younger groups' survival rates with a larger group of older women who were diagnosed up to age 65, they found that survival rates were lower for the younger women.

The authors noted that their findings contribute to the current disagreement among researchers as to whether or not young women are more likely to develop more aggressive forms of breast cancer than older women.

"The current study suggests that among young women with breast carcinoma there is no difference in prognosis between the very young and the young," they concluded, although they did find a difference when these women were compared to older patients. This makes it especially important, they wrote, to select the appropriate treatment strategy for younger patients based on their potentially more aggressive disease.

"Despite two thirds of [the younger] patients being node negative," they wrote, "the high mortality rate indicates a need for an optimal selection of adjuvant therapy among these cases."

SOURCE:
Cancer, February 1, 2002; 94:606-614