Slight increase found in metastatic breast cancer in young women

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Metastatic breast cancer which has already spread on initial presentation was found to have increased slightly among young women, ages 25 to 39, a 34-year analysis suggests. More research is needed to verify the finding, and scientists are not sure what may have caused the apparent increase.

The study, published in JAMA, analyzed data from SEER, a program run by the National Cancer Institute to collect cancer statistics. From the 936,497 women the study was based on, researchers found that advanced cases increased to 2.9 per 100,000 younger women in 2009, from 1.53 per 100,000 women in 1976 an increase of 1.37 cases per 100,000 women. The totals were about 250 such cases per year in the mid-1970s, and more than 800 per year in 2009.

It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital. But Dr. Johnson noted that there is no evidence that screening helps younger women who have an average risk for the disease and no symptoms. We re certainly not advocating that young women get mammography at an earlier age than is generally specified, she told the New York Times.

Dr. Silvia C. Formenti, a breast cancer expert and the chairwoman of radiation oncology at New York University Langone Medical Center, questioned the study in part because although it found an increased incidence of advanced disease, it did not find the accompanying increase in deaths that would be expected.

Furthermore, a spokeswoman for an advocacy group for young women with breast cancer, Young Survival Coalition, said the organization also wondered whether improved diagnostic and staging tests might explain all or part of the increase. We re looking at this [sic] data with caution, the spokeswoman, Michelle Esser, told the Times. We don t want to invite panic or alarm.

When a young woman presents with incurable breast cancer, anyway you slice it it s a tragic situation, says ACSH s Dr. Gilbert Ross. However, we should keep perspective and not take statistics out of context to engender needless anxiety. First, the apparent increase may be due mainly to better diagnostic tools in recent years; further, the absolute number of such cases is quite small. Women and their physicians should be cautious, but this study should not initiate panic among young women.