Breast Cancer Advances

Young Women’s Program Provides Advanced, Specialized Breast Cancer Care

Young women diagnosed with breast cancer not only face decisions about treatment and fear of cancer recurrence, but often contend with issues unique to their young age. In particular, young women are more likely to have genetic predisposition to breast cancer and be concerned about how treatment will affect their fertility.

Recognizing that young women face different issues than older women upon receiving a breast cancer diagnosis, Ann Partridge, MD, MPH, Clinical Director, Breast Disease Center, Dana-Farber/Brigham and Women’s Cancer Center, and Eric Winer, MD, Director, Breast Oncology Center, Dana-Farber/Brigham and Women’s Cancer Center, began
to focus research on this population.

In one of their first studies, they examined fertility concerns in a national sample of young women with a history of breast cancer. They conducted an internet-based survey of 1,700 young breast cancer survivors. The work, reported in the Journal of Clinical Oncology (J Clin Oncol. 2004 Oct 15;22(20):4174-83), identified a need for better communication with young patients about fertility issues, as well as a need for research into treatments that preserve fertility among young breast cancer survivors.

This, and other studies identifying areas for improvement in care, led Drs. Partridge and Winer to establish the Program for Young Women with Breast Cancer in 2005. This Program, directed by Dr. Partridge, aims to:

• Support young women through their treatment;
• Educate both young women and their providers about the unique concerns of young women with breast cancer;
• Provide a model of comprehensive care intended to be adapted outside of the Dana-Farber/Brigham and Women’s Cancer Center;
• Conduct research aimed to improve our understanding of breast cancer in young women – including biology of the disease, response to therapy, and psychosocial and survivorship concerns.

“The Program brings together clinical researchers as well as basic and translational scientists from many fields including, pathology, medical oncology, radiation oncology and surgery as well as genetics, reproductive endocrinology, medical decision making, and more, making care highly multi-disciplinary, and research extraordinarily collaborative and translational,” said Dr. Partridge.

“For the clinical care of patients in the Program, we help organize resources, such as fertility services, genetic screening, and psychological counseling, for young women to address their unique concerns. We want to be certain there are no missing pieces in care,” said Dr. Winer. Patients also receive support from a social worker and access to telephone and drop-in support groups.

The Program also reaches out to patients with a regular newsletter and hosts community-building events such as Survivor Evenings and an annual regional conference for patients. “Young women definitely feel more comfortable here and appreciate the extra services,” said Dr. Partridge.

Expanding Care for Young Women

The success of the Program has inspired expansion of clinical care and research beyond the local model program.

• The Virtual Young Women’s Initiative

Dr. Partridge received a three-year $1.35 million American Society of Clinical Oncology (ASCO) Cancer Foundation Improving Cancer Care Grant, funded by Susan G. Komen for the Cure. The grant supports her efforts to expand the domain of the Young Women with Breast Cancer Program into a virtual program, called the Young and Strong Program, that will reach women around the country.

The virtual program will pilot and study exportable and sustainable educational and support materials for young women with breast cancer and their caregivers. Materials and interventions will include a community website that is geared to help patients and their doctors understand and address the concerns of young women. It will offer materials geared towards patients, such as booklets, videos, Questions for the Doctor, and resource links, and materials for oncologists such as checklists, book chapters, and clinical expert email access.

Dr. Partridge is working with Co-principal Investigator Karen Emmons, PhD, Associate Dean, Research, in the Department of Society, Human Development, and Health, at the Harvard School of Public Health and a behavioral scientist with expertise in community-based research, to design the program and conduct the research. The team plans to export the model of care in the local Program for Young Women with Breast Cancer to community cancer settings and then study the effect of the expanded program on fertility issues and other measures of quality of care, satisfaction, and quality of life. They will evaluate the impact of their program versus an exercise-based intervention in a randomized clinical trial.

• Helping Ourselves, Helping Others

In 2006, Dr. Partridge launched the first multi-institutional cohort study of young women diagnosed with breast cancer. The Helping Ourselves, Helping Others study has already enrolled more than 500 young women. The researchers will follow these women for 10 years, banking blood and tissue for biological analyses to better understand the unique biology of breast cancer in young women, as well as tracking the medical and psychosocial issues these women face at diagnosis and throughout treatment.

For more information on all of these programs and studies, please contact Principal Investigator Ann Partridge, MD, MPH, at (617) 632-3800, ahpartridge@partners.org.

Ann Partridge, MD, MPH
Clinical Director, Breast Oncology Center;
Director, Program for Young Women with Breast Cancer

Eric P. Winer, MD
Director, Breast Oncology Center
Dana-Farber/Brigham and Women’s Cancer Center


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