Young women's breast cancer risk

Main Category: Cancer / Oncology
Article Date: 03 Nov 2003 - 0:00 PDT

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Young women who have a cancerous lump removed from their breast may have a high risk of developing the disease again, say experts.

A study by French doctors has found they are more likely to be diagnosed again with breast cancer compared to older women who have lumps removed.

They are also more at risk than women who have their breast removed.

Writing in the Annals of Oncology, the doctors urged young women who have lumpectomies to have regular check-ups.

Cancerous lumps

Dr Rodrigo Arriagada and colleagues at the Institut Gustave-Roussy and INSERM in France based their findings on a study of 179 patients.

All of these women had been treated for breast cancer in the 1970s. Of these, 88 had a cancerous lump removed while 91 had a mastectomy or breast removed.

They found the type of treatment these women received had no impact on the length of their lives.

They also found that women who had their breast removed were five-times more likely to develop breast cancer again in the five years after their treatment compared to those who had a lumpectomy.

But beyond five years they found that women who had a lump removed were 12 times more likely to develop the disease again compared to those who had a mastectomy.

The doctors then analysed the medical records of another group of patients. These included 632 women who had lumpectomies and 1,215 who had mastectomies.

'We found a similar result in the database patients,' said Dr Arriagada.

The doctors believe that the risks are greatest for women who have lumps removed when they are young, under the age of 40.

Further study

Dr Arriagada said further studies are needed to back up these findings.

He acknowledged that recent advances in breast cancer treatment, including new drugs, could mean that women who have lumps removed now do not run the same risks as those who had treatment in the 1970s.

But he said if other studies back up the findings, women should be told of the risks. He added that they must also be told that they will need regular check-ups, potentially for the rest of their lives, to ensure they remain healthy.

'If these results are corroborated, younger patients should be informed of the higher risk of local recurrence and the need for indefinite follow up if they choose conservation treatment,' he said.

'This information should be given to patients to enable them to choose between breast conserving surgery and mastectomy with breast reconstruction.'

Dr Michelle Barclay from Breakthrough Breast Cancer said: 'It is crucial to remember that there have been huge improvements in the past 20 years in both surgery and treatments, such as tamoxifen - which is not taken into consideration in this study which began in the 1970s.

'These have resulted in a significant increase in survival.

'The decision to have a lumpectomy or mastectomy for any women is very difficult. However, where this choice is available it has to be an informed one.

'Clearly the impact of the type of surgery on recurrence is a significant part of the decision making process.'

Dr Richard Sullivan of Cancer Research UK said: 'This is a very interesting scientific study which is at a very early stage.

'Women in their 20s or early 30s who have had a lumpectomy shouldn't be alarmed.

'They are checked regularly throughout their lives, and their treatment shouldn't be changed because of this report.'

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