Younger breast cancer survivors face bigger hurdles

Breast cancer takes a daunting toll on all women, but it hits younger women especially hard, finds a new study from the Brown School at Washington University in St. Louis.

Women aged 18-44 with a history of breast cancer reported a lower health-related quality of life than older survivors, highlighting the impact of breast cancer on the physical and mental health of younger women.

For younger women, the effect of breast cancer on quality of life was 70 percent greater than that of other cancers.

The study, led by Derek Brown, PhD, assistant professor at the Brown School, was published in the American Journal of Preventative Medicine.

Brown and his colleagues analyzed data from the 2009 and 2010 Behavioral Risk Factor Surveillance System. The sample included 218,852 women; 7,433 had a history of breast cancer and 18,577 had histories of other cancers. Health state utility (HSU) values, a scaled index of health-related quality of life for economic evaluation, were estimated using survey questions and a published mapping algorithm.

"One possibility to explain these results is that younger women are nearer to peak childbearing ages, so they are more concerned about fertility implications of treatment," Brown said.

"Even if the treatments have the same physical impact across ages, the stress and mental health impacts may be larger for younger women, and show up as larger impacts on health-related quality of life," he said.

Another possible reason for the finding, Brown said, is that breast cancers in this study could be more advanced when diagnosed in young women compared to older women, since routine screening is not recommended in younger women.

"If so, this could mean larger mental or physical health impacts, and a greater impact on quality of life," Brown said. "We would need a more detailed clinical sample data set to test this."