Age and Breast Cancer: Mind the Gap

I was very excited this morning to see that some folks at the National Cancer Institute are concerned about the gap in our knowledge about breast cancer in different age groups, and the need to address this in research studies.  This is something I’ve been concerned about for awhile.  Over and over studies are showing that breast cancer in younger women behaves differently, and yet many treatment decisions for younger women are based on research studies with a majority of subjects having post-menopausal breast cancer.

So I was thrilled to see the commentary in the Journal of Clinical Oncology this morning by Dr. William F. Anderson, of NCI’s Division of Cancer Epidemiology and Genetics and his colleagues, “Qualitative Age Interactions in Breast Cancer Studies: Mind the Gap.”

They are encouraging breast cancer researchers to consider stratifying randomized control trials into different age groups for analysis.  By not taking age into account, current studies may be blurring age-specific sub-group effects, they say.

By stratifying by age to look at results of treatments, they point out it could benefit not only younger patients, who perhaps need more aggressive treatment than has previously been shown, but also older patients who may not actually derive as much benefit from treatments as previously thought, and might be able to avoid some of the harsh side effects from these treatments.

The authors contend that the age interactions are also more complex than a simple difference between pre- and post-menopausal age groups.  For instance, number of pregnancies increases breast cancer risk among women younger than 30 to 44 years but decreases risk among older women . And obesity is protective for women younger than 50 years but increases risk thereafter.

The authors conclude by saying that analysis of age-specific effects in randomized trials may help fill our gap in knowledge and understanding about tumor biology and optimize treatment until better markers are discovered for evaluating tumor characteristics and behavior.

Let’s hope the researchers are listening!

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Comments

  • Tami Boehmer  On October 16, 2009 at 1:15 pm

    This is great to hear. It’s hard to believe they haven’t already done this. I’ve heard for years how breast cancer is more aggressive in young women. Thanks for the information.

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