DESCRIPTION: This application for a competitive renewal of "Factors that
affec survival of young breast cancer patients", seeks to extend for five
more years the follow-up for recurrence and mortality of a population-based
cohort of 128 women who were diagnosed with invasive breast cancer before
age 45 during the years 1983 through 1992. These women provide the
investigators with a unique opportunity to investigate the
interrelationships between epidemiologic risk factor data, tumor
characteristics, and breast cancer occurrence and/or mortality in a
population-based setting where all cases of breast cancer in a defined
geographic area could be assessed, eliminating potential biases impose by
studies at referral centers or clinical trials, where women may self-select
into the study and not be representative of women in general who get breast
During the past five years, this cohort was followed through follow-up
questionnaires and hospital chart reviews, and their tumor specimens were
tested for characteristics related to aggressiveness and prognosis. It is
important to extend follow-up of this cohort to a minimum of ten years since
patient and tumor characteristics may have different relationships with
short and long-term mortality. During the next five years, the
investigators propose to (a) expand data collection and specimen analyses to
the entire cohort (rather than the subgroup of 930 they originally
proposed), (b) extend the minimum follow-up period for the entire cohort to
ten years, (c) collect updated information on recurrences, treatment, the
use of hormone replacement therapy and childbearing after diagnosis, (d) add
apoptotic index to the laboratory analyses, and (e) conduct comprehensive
analyses of all of these data in relation to mortality and disease-free
Young women with many years of potential life to lose who do not fall into
clear prognostic categories present a major challenge to clinicians. By
gainin an understanding of the association between epidemiologic risk
factors and tumor characteristics related to aggressiveness as well as
actual risk of recurrence or death, it is possible to develop profiles of
women at high risk for aggressive tumors who might benefit from aggressive
treatment and of those with low risk tumors for whom such aggressive
treatment may not be necessary.
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