Younger More Ferocious Breast Cancer

Breast cancer in young women biologically unique

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Though still rare, when breast cancer shows up in women in their 30s, it's not a kinder, gentler form of the disease. Quite the opposite. Scientists are beginning to understand why this is and what interventions might calm its cruelty.

The biological basis and behavior of breast cancer in young women is quite different from the disease that appears in older, postmenopausal women.

And this unique disease requires individualized treatment and management strategies.

"Talk to your OB/GYN about when to begin breast cancer screening."

In a report presented at  the 4th IMPAKT Breast Cancer Conference, held in Brussels, Belgium, researchers noted that learning the biological mechanisms behind breast cancer in younger women is critically important. It opens paths to quell a disease that's particularly aggressive and lethal.

Dr. Hatem A. Azim Jr., a medical oncologist from Institut Jules Bordet in Brussels, and colleagues found that breast cancer in women under the age of 40 has what's known as "basal-like tumors," These tumors are fast growing, invasive and are quite likely to return after treatment. 

Dr. Azim wanted to know why. There has been a theory that younger women are less rigorous about complying with hormone therapy, but that's not the case.

Analysis of  1,188 women who didn't receive chemotherapy found that women with luminal-A and luminal-B tumors had poor outlooks. Luminal-A cancers are estrogen receptor positive (ER+) and low-grade, while Luminal-B cancers are ER+ but often high grade. The higher the tumor grade, the poorer the prognosis.

Next, the researchers studied the types of genes in young breast cancer patients. They wanted to see how age fit into the equation. They analyzed the genetic make-up of the tumors in 1,188 and 2,334 patients (two different data sets), and found the same results.

Basically, there are "several genes and gene signatures that are significantly associated with age in breast cancer patients," Dr. Azim explained.

The bottom line is that young women have a distinct type of disease that's associated with certain age-related biological processes.

In particular, researchers found that young women with breast cancer have high levels of a gene called RANKL. This gene is involved in the spread of cancer to the bones. It may also have anti-tumor properties, interestingly.

Armed with this information, the scientists think that targeting RANKL may be helpful, and a clinical trial to test this theory is being planned. One week before surgery, premenopausal breast cancer patients will receive two injections of a drug called denosumab, which blocks RANKL.

Commenting on the study (which he was not involved in), Prof Bryan Hennessy, from Beaumont Hospital in Dublin, said: "This study provides evidence that breast cancer in young women is associated with unique underlying biologic processes, highlighting important information that may allow us to design tailored therapy approaches to improve outcomes in this population."

Research is considered preliminary before it's published in a peer-reviewed journal.

No funding information or financial disclosures were provided.

Reviewed by: 
Review Date: 
May 7, 2012
Last Updated:
May 8, 2012