The Value of Research on Women

To young women, Friday’s article by Times medical writer Thomas H. Maugh II looked like bad news: Women who are pregnant when breast cancer is diagnosed are three times more likely to die of the disease and the effect doesn’t fade entirely until five years after the last pregnancy. But, paradoxically, the end result of this knowledge will be fewer deaths.

The international research led by doctors at the M. D. Anderson Cancer Center in Houston and reported today in the medical journal Lancet is the sort of gender-specific research that women’s organizations have long called for. Doctors always knew that younger women died more often of breast cancer, and that many cancers, in both men and women, are more virulent in younger people. Now that pregnancy is known to be such a large factor, more research is indicated to determine which hormonal or immunological factors of pregnancy are involved in raising the risk and whether women with high known risk factors for breast cancer are particularly vulnerable. Knowledge is the first prerequisite to better prevention and treatment.

While this research is somber news, it is not a reason for women to fear pregnancy. Breast cancer is rare in young women, hitting only one woman in 2,426 by age 30, compared with one in eight over a lifetime. And not all women are at equal risk of contracting breast cancer while young. Earlier research has shown a much higher risk for women with a strong familial pattern of breast cancer, peaking in women whose mothers had pre-menopausal cancer in both breasts.

This latest report is part of a recent spate of studies on breast cancer, including one that found better survival results for pre-menopausal breast cancer patients who had surgery at mid-cycle, near the time of ovulation.

That breast cancer is apparently exacerbated by the hormonal and immunological changes of pregnancy is not much of a surprise, but no one had done the research.

There are other sorts of gender-specific research that need similar attention, particularly the inclusion of women in trials of new drugs. Almost all of what we know about the safety and efficacy of drugs comes from trials on adult men, for reasons including worry that a trial participant might be pregnant. But the breast cancer findings are proof of the benefits of gender-specific studies.