Late stage breast cancer in young women is increasing in frequency according to a new report that analyzed the U.S. National Cancer Institute Surveillance, Epidemiology and End Results (SEER) database. The incidence of Stage IV breast cancer in young women has increased at a rate of about 2% a year since 1976. Although the absolute number of young women who are diagnosed with advanced disease is a small one, it has doubled from 1.5 women per 100,000 to 2.9 per 100,000. This increased incidence of Stage IV disease was found in young women of all races, but was especially prominent in blacks and non-Hispanic whites.
Breast cancers with estrogen positive characteristics were responsible for this increase compared with estrogen negative ones. The study noted that the frequency of localized disease did not increase in this group. No other age group experienced significant increases in local, regional or stage IV disease during the study period. Young women are thought to have more aggressive disease than older women even when all other factors are equal. Although nonendocrine sensitive cancers (e.g. triple negative ones) are thought to be more aggressive and more common in young women, the increase in Stage IV disease at diagnosis seemed to be caused by estrogen receptor positive disease. The study did not investigate what might be cause of this increase in Stage IV ER positive tumors.
Physicians have to be alert to the possibility of breast cancer in young women, since early diagnosis at an earlier stage is still the most important determining factor of the woman's chances for cure. Britcher Leone & Roth have experience in determining whether there was a delay in diagnosis of cancer that allowed the disease to spread to a more advanced stage causing a reduction in chances for cure. Only a detailed analysis of the facts of each case can tell if death or serious disability was avoidable.