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The evidence suggests that all should be treated with adjuvant therapy
| The first 150 words of the full text of this article appear below. |
Breast cancer is uncommon in young women, but
when it strikes it has a devastating effect on patients and their
families. Several studies have shown that women who develop breast
cancer in their 20s and 30s have worse survival and more biologically aggressive cancers with higher rates of proliferation and
lymphovascular invasion and lower levels of oestrogen receptors than
older patients with cancers of the same stage.1 Yet
despite their apparently worse survival, younger women get more benefit
from chemotherapy than older women. An overview of randomised trials
showed that patients with operable breast cancer aged under 40 have a
37% (SD 7) proportional reduction in the odds of recurrence and a 27%
(SD 8) reduced risk of death with adjuvant chemotherapy compared with
reductions of 20.3% (SD 2.6) and 11.3% (SD 2.9) respectively for
women aged 50-69.2 These proportionally greater benefits from adjuvant chemotherapy seem to be independent of node