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Young Age at Diagnosis May Not Predict Outcome

Study at one institution suggests similar survival regardless of age when diagnosed

July 17, 2012

Written By Robin Warshaw
Reviewed By Kala Visvanathan, MBBS, FRACP, MHS

Being under 40 years old when diagnosed with breast cancer does not predict a worse outcome, one study shows.

The study from Ireland, published in BMC Cancer, determined that although breast cancer in younger women had distinct features, there was no significant difference in overall survival when compared with women diagnosed after 40. Overall survival measures time living after diagnosis, whether cancer returns or not.

Background and Reason for Study

The question of whether young age at diagnosis by itself predicts reduced survival has been explored by researchers, with conflicting results, for years.

Several factors could influence survival. Younger women do not receive routine screenings, so diagnosis might be delayed, and the disease may reach a later stage before detection and treatment. Common screening methods like mammography may also fail to detect cancers in young women, who tend to have dense breasts. Being younger also might increase the chances of having a breast cancer with certain biological traits, such as hormone receptor negativity, that limit treatment options. 

The researchers conducting this study wanted to:

  • identify how often a first breast cancer happened in women under 40;
  • analyze the traits (tumor grade, stage, hormone receptor status, etc.) of breast cancers in that population;
  • determine survival outcomes;
  • compare those results with women older than 40 when diagnosed.

Study Structure

The study looked at information gathered over a 20-year period for 2,869 women in one hospital’s breast cancer database. All the women consented to have their data included. All participants were Caucasian, due to the makeup of this hospital’s population.

Statistical analysis considered age, tumor size, grade, stage, lymph node involvement and metastasis, if any. Hormone receptor status and therapies, when available, were also noted.   

There were 276 women under age 40 in the database—or 8.8 percent of the total with breast cancer. To analyze the data on survival, each younger woman was matched with two women over 40 whose disease stage and grade matched the younger woman’s most closely.

Findings

Younger women in this study were more likely than older women to be diagnosed with breast cancer that had aggressive traits. These markers included higher grade and later stage, as well as being estrogen receptor-negative (ER-) and HER2 positive (HER2+). Most women in both groups had progesterone receptor-positive (PR+) cancers. The groups had no statistical difference in tumor size.

Although the findings agree with other recent research showing what the authors call “biologically unfavorable breast cancer among younger women,” they found no significant difference in survival—with or without cancer returning—between women under 40 at diagnosis or those who are older.

Because the researchers looked at data from only one hospital, more research is needed to confirm these findings.  

What This Means for You

Receiving a breast cancer diagnosis as a younger woman can be scary and upsetting. You may even have heard that breast cancer is worse in young women. Although early, this study may help you feel more assured that being young does not automatically mean you will have a poorer outcome.

You may have questions or just want to talk with another young woman diagnosed with breast cancer who understands your concerns. If so, call our Breast Cancer Helpline toll-free at (888) 753-LBBC (5222) for confidential peer support and information.                                                  

EH Kheirelseid, JM Boggs, C Curran, et al. Younger age as a prognostic indicator in breast cancer: A cohort study. BMC Cancer 2011; 11: 383.

 

This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

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