Patients with Breast Cancer Age Faster Than Cancer-Free Women

Women who have received a diagnosis of and treatment for breast cancer tend to age faster than cancer-free women, according to a new study.

The study from researchers at the National Institutes of Health and their colleagues, published July 19 in JNCI: Journal of the National Cancer Institute, found that “the biologic age of people who were treated for breast cancer appears to be slightly older,” co-author Dale Sandler, chief of the NIH’s National Institute of Environmental Health Sciences Epidemiology Branch, told CURE®.

“And when I say slightly, I mean something that might translate to a six- to 12-month difference in biologic age,” Sandler said. “Now, what this means for patients at this point is (that) we already know that being diagnosed with breast cancer and then the ensuing treatments is a grueling process, and women themselves may feel that it has aged them, and so this is sort of scientific documentation (of that).”

Regarding long-term implications, Sandler said the study’s findings suggest that there is “additional work that we might do as scientists researching this and as clinicians to pay attention to screening, watching for age-related changes and age-related diseases that can be intervened in early.”

Researchers studied 417 participants of the Sister Study, examining a pair of blood samples from each patient drawn an average of 7.7 years apart to evaluate the patients via three metrics — PhenoAgeAccel, GrimAgeAccel and Dunedin Pace of Aging Calculated from the Epigenome (DunedinPACE) — of measuring biological age, or a patient’s cell and tissue health.

“The researchers used three different established ‘methylation clocks’ to determine if there were changes in a women’s biological age between the two time points,” the NIH explained in a press release on the study’s findings. “The clocks measure naturally occurring, chemical modifications to a person’s DNA, known as methylation changes. Small variations in methylation patterns can help determine a person’s risk of developing an age-related disease.”

Slightly less than half (190 patients) of the participants had received a diagnosis of and treatment for breast cancer in the years between blood samples, with the diagnosis happening an average of 3.5 years after the initial blood draw and four years before the second draw, according to the study, and patients with breast cancer had faster aging rates when measured by all three clocks.

Participants who received a diagnosis of breast cancer prior to the second blood draw had a mean age of 57 at the time of enrollment, compared to a mean age of 55 for cancer-free participants. Researchers found that surgery “had little association with the biological aging metrics but that the women receiving other treatments, particularly radiation, had increases in all three biological aging metrics.”

The authors posited that their findings enforce the hypothesis that radiation treatment “has long-term consequences for leukocyte (white blood cell) composition and biological aging metrics and may further inform discussion of limiting radiation treatment for breast cancer when possible.”

In its press release on the study, the NIH was sure to communicate researchers’ stance that patients should not avoid radiation therapy due to these findings.

“Current breast cancer treatments that include radiation are very effective in preventing breast cancer from spreading,” the press release stated.

“We know that radiation can be a very effective either single, main treatment or adjunct to chemotherapy for treating patients with breast cancer,” said Sandler, who noted that the difference in biologic age associated with radiation treatment is three to five or six months.

Due to a lack of any connection between biological aging metrics and time from diagnosis, the authors stated that their findings “provide support for the hypothesis that breast cancer

survivors have lasting increases in biological aging that persist for years after diagnosis and treatment.”

“In part because the research sort of indicates what women themselves say, this is a call to pay attention,” said Sandler. ‘We know that women with breast cancer have increased rates of developing cardiovascular disease, or they develop it younger, they develop chronic diseases earlier.

“So, I think greater attention (could be paid) to supporting women with breast cancer medically, to prevent other conditions associated with aging. … I think this is a very important finding. And our study was small, and we're hoping to repeat this on a larger scale with a with a larger sample of our participants.”

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