In recent years, breast cancer has been known to kill as many as 1% of all the people that die worldwide - around 519,000 people, men and women both. It is also an odd disease, in that it is one of the few in which being younger does not seem to increase your chance of survival. In fact, hospitals in Bangkok now know that because the cancer needs to overcome stronger bodily systems in younger women in order to establish itself, only the most resilient forms of the disease are able to take hold. This fact is what drove a recent study into the options for breast cancer treatment for younger women, and which offer better survival rates and lower incidences of recurrence. Thailand cancer centers are now using the information to better advise their patients on which treatments offer them the best chance of recovery.
A research team at the University of Texas MD Anderson Cancer Center recently looked at the different types of breast cancer therapy that international hospitals in Bangkok offer. The three types of treatment were breast conserving therapy, mastectomy on its own, and mastectomy with adjuvant radiation. The patients involved in the study were categorized that same way that Thai breast cancer patients are, as having either Stage I or Stage II disease. The study spanned several decades of patients, from 1983 to 2006. Roughly equal numbers received each different treatment, with 197 having breast conserving therapy, 237 having a mastectomy and 234 a mastectomy with adjuvant radiation also.
The study authors first confirmed that younger Thai breast cancer patients do have higher recurrence rates of cancer. Patients with Stage II disease benefited most from a more intensive therapy to begin with - mastectomy with adjuvant radiation gave them better outcomes. For younger patients with Stage I disease, all three treatments seemed equally effective in reducing recurrence. However, adding chemotherapy to any of the treatments was an advantage for them.
Previous studies had looked at the risk of recurrence when patients with hereditary breast cancer undergo breast conserving therapy. It found no increased risk of recurrence in this case - however, a patient's age was not one of the study metrics. The collective results of other randomized trials, spanning the period 1972 to 1989, showed no significant difference in the outcome for patients whether breast conserving therapy or modified radical mastectomy was used. This encouraged doctors in Thai cancer centers, who continued to advise women that whatever treatment they felt most comfortable with would be best for them. All were seen to have equal survival and recurrence rates. However, this was before the understanding that younger women usually have a more biologically aggressive form of cancer came to be common medical knowledge. Now, hospitals in Bangkok will be adjusting their patient advice to ensure that younger patients are aware that the more radical treatments will offer them the best hope for long term survival.
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