Clinical and Epidemiologic Research in Breast Cancer
Breast cancer is the most common malignancy in U.S. women, with over 215,000 new cases diagnosed in 2005. Although the median age at breast cancer diagnosis is approximately 65, more than 14,000 women 40 years of age or younger are diagnosed with breast cancer each year in the United States. Because women in this younger age group represent a minority of the women diagnosed with breast cancer, far less is known about breast cancer in younger women than older women. Evidence shows that young age is an independent risk factor for disease recurrence and death. It is controversial whether the poorer prognosis is a reflection of delays in diagnosis or differences in biology, but accumulating evidence indicates that biologic differences may play an important role. In addition to being at higher risk of dying from breast cancer than older women, young women with breast cancer are at increased risk of psychosocial distress at diagnosis and in follow-up when compared with older women. Young women with breast cancer face a variety of unique medical and psychosocial concerns as a result of their diagnosis and subsequent treatment. In particular, fertility and family planning, menopausal symptoms, and sexual functioning are of great concern to this patient population. Our research focuses on the psychosocial, behavioral, and communication issues associated with breast cancer care, especially the unique issues facing young women with breast cancer. Several ongoing projects include evaluation of adherence with hormonal therapies in women with early-stage breast cancer, assessment of fertility and fertility concerns in young women undergoing breast cancer treatment, and communication of study results to patients following clinical trial participation.