Know Cancer

forgot password

Young and Strong: An Education and Supportive Care Intervention Study for Young Women With Breast Cancer

18 Years
45 Years
Open (Enrolling by invite only)
Breast Cancer

Thank you

Trial Information

Young and Strong: An Education and Supportive Care Intervention Study for Young Women With Breast Cancer

Breast cancer in young women is a not a common disease, yet over 12,000 women under 40 are
diagnosed with invasive breast cancer yearly in the United States alone and an additional
2000 are diagnosed with noninvasive disease. Furthermore, when young women are diagnosed
with breast cancer, the burden of the disease and treatment on this population is great.
Breast cancer is the leading cause of cancer-related deaths in women under 40, and survival
rates for young women with breast cancer are lower than for their older counterparts

In addition to being at higher risk of dying from breast cancer, and therefore usually
receiving more aggressive therapy, young women are at higher risk of distress both at
diagnosis and follow-up. Young women with breast cancer face a variety of problems unique
to or accentuated by their young age (1). They are more likely to be diagnosed at a stage
in life when they fill multiple roles that may not easily be taken over by others (e.g.
parenting of young children, completing education, developing a career). Concerns with
attractiveness and fertility are often of substantial importance in this population, as many
young women are interested in having biologic children following treatment. They also have
a greater risk of harboring a genetic risk factor for breast cancer than older patients.
Finally, more than older women with breast cancer, who represent the majority of women with
the disease, young women often feel isolated and feel that they lack information, and they
sometimes are concerned that their doctors are unsure of how to treat them (2,3). Distress
may be confounded by a lack of information, provider awareness, peer support, and resources
to address young women's concerns, which may contribute to the greater psychosocial distress
seen in younger women at both diagnosis and in follow-up compared with older women (4-14).
Thus, attention to these concerns in young breast cancer patients is warranted.

Available evidence, however, suggests that attention to important supportive care and
survivorship issues including fertility, menopausal concerns, body image, sexual
functioning, genetic risk, and psychosocial health have been repeatedly found to be
deficient in treatment of young women (15,23-28). Many groups, including ours, have
demonstrated that there are substantial inadequacies in attention to fertility and
menopausal risks in this population despite recent guidelines recommending their
consideration with every young patient (15-20).

Weight gain is another common concern in women diagnosed with breast cancer and has been
associated with reductions in physical activity. Studies have demonstrated that 68% of women
with early stage breast cancer gain weight after diagnosis and women who receive
chemotherapy are at highest risk of weight gain, especially premenopausal women who go
through menopause with treatment (33-36). Some evidence suggests that exercise may help
prevent treatment-related weight gain and improve psychological outcomes in women diagnosed
with early stage breast cancer (38-40). Importantly, exercise and lack of weight gain have
been repeatedly associated with improved disease outcomes in breast cancer survivors

Again, available evidence suggests the majority of breast cancer survivors do not
participate in regular physical activity and that there is clearly room for improvement
(43-45). Currently, encouraging physical activity is not a well-recognized standard in
breast cancer care, and interventions to assist patients and providers to increase patient
exercise behaviors in standard oncology care are needed.

Among older women, access to information and psychosocial support is associated with better
quality of life in breast cancer survivors. However, there are no data available to indicate
how these processes operate in younger women specifically or what services might mitigate
psychosocial distress (29-32). We believe that attention to the issues in young women with
breast cancer that are outlined above may be associated with better satisfaction with
quality of care and treatment decisions, decreased distress, and better overall quality of

To address these critical issues, we have developed a comprehensive Program for Young Women
with Breast Cancer at Dana-Farber Cancer Institute (DFCI) to provide additional care,
support, and education for young women with breast cancer. Based on the preliminary success
of this program, we seek to export this unique model of care to young women with breast
cancer who receive care outside of comprehensive cancer centers in an effort to improve the
quality of care delivered, the satisfaction with care, and the psychosocial well-being of
this vulnerable population.

In the proposed study, we will build on our previous work that developed and piloted an
educational and support intervention to improve the quality of care delivered to young women
with breast cancer. To achieve these aims, we have created educational interventions
focused on issues faced by young women with breast cancer, including but not limited to
fertility, satisfaction with care, and physical activity. We will use piloted components of
the Program for Young Women with Breast Cancer, as well as piloted exercise intervention
materials, to create two educational interventions for this population.

We plan to evaluate both interventions in a randomized controlled trial (RCT) in which
community and academic practices and their respective patients will be randomized to an
intervention that either focuses on issues unique to young women with breast cancer (Young
Women's Intervention, or YWI) or one that focuses on leading a healthy lifestyle as a breast
cancer patient (Physical Activity Intervention, or PAI). The rigorous study design of this
research will provide important information on the effects of these interventions to improve
the care of young women with breast cancer. Therefore, through our intervention, we hope to
elucidate what factors might improve quality of life in young women with breast cancer.
Ultimately, this work should provide a model for intervening to improve the care of other
unique populations.

Inclusion Criteria:

- Female age 18-45 years at diagnosis

- Within 3 months of stage I-III invasive breast cancer diagnosis

- No known recurrence or metastatic disease

- Able to read and write in English

- Has first appointment with medical oncologist after the provider's practice is
enrolled in the study

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Supportive Care

Outcome Measure:

Comparison of attention rates in the YWI and the PAI

Outcome Description:

The YWI and PAI arms will be compared in terms of the attention rate at 3 months using generalized estimated equations (GEEs) to account for clustered binary data. Comparison will be based on testing the term for treatment arm.

Outcome Time Frame:

3 Months Post-Enrollment

Safety Issue:


Principal Investigator

Ann H Partridge, MD, MPH

Investigator Role:

Principal Investigator

Investigator Affiliation:

Dana-Farber Cancer Institute


United States: Institutional Review Board

Study ID:

DFCI 12-101



Start Date:

June 2012

Completion Date:

December 2014

Related Keywords:

  • Breast Cancer
  • Breast Cancer
  • Young Women
  • Fertility
  • Physical Activity
  • Survivorship
  • Breast Neoplasms



Johns Hopkins University Baltimore, Maryland  21205
University of Michigan Ann Arbor, Michigan  48109-0624
Roswell Park Cancer Institute Buffalo, New York  14263
Mary Bird Perkins Cancer Center Baton Rouge, Louisiana  70809
Northside Hospital Cancer Center Atlanta, Georgia  30342-1611
Fox Valley Hematology and Oncology Appleton, Wisconsin  54911
University of Washington Seattle, Washington  98195
University of North Carolina Chapel Hill, North Carolina  27599
University of Pennsylvania Philadelphia, Pennsylvania  19104
West Clinic Memphis, Tennessee  38117
Emory University Atlanta, Georgia  30322
Albert Einstein Medical Center Philadelphia, Pennsylvania  19141
Ohio State University Columbus, Ohio  43210
Providence Portland Medical Center Portland, Oregon  97213-3635
University of Chicago Chicago, Illinois  60637
Indiana University Indianapolis, Indiana  46202
Edward Hospital Naperville, Illinois  60566
Billings Clinic Billings, Montana  59107-7000
Northern Westchester Hospital Mount Kisco, New York  10549
Cookeville Regional Medical Center Cookeville, Tennessee  38501
Baptist Hospital East Louisville, Kentucky  40207
Norton Cancer Institute Louisville, Kentucky  40207
St. Francis Medical Center Grand Island, Nebraska  68803
NorthShore University HealthSystem Evanston, Illinois  
MaineGeneral Medical Center Augusta, Maine  
Christus St. Frances Cabrini Hospital Alexandria, Louisiana  71301
Space Coast Cancer Center Titusville, Florida  32796
Cancer Center of South Florida Lake Worth, Florida  33461
Self Regional Healthcare Greenwood, South Carolina  29646
Santa Monica Hematology-Oncology Consultants Santa Monica, California  90404
Penrose St. Francis Health Services Colorado Springs, Colorado  80907
Oncology Specialists Research Institute Niles, Illinois  60714
Overland Park Regional Medical Center Overland Park, Kansas  66209
Center for Breast Health Bethesda, Maryland  20817
St. Luke's Hospital of Kansas City Kansas City, Missouri  64111
South Shore Hematology Oncology Valley Stream, New York  11580
Oncology Specialists of Charlotte Charlotte, North Carolina  28207
Baptist Hospital of Southeast Texas Beaumont, Texas  77701
Texas Oncology- Round Rock Round Rock, Texas  78681
Shenandoah Oncology Winchester, Virginia  22601
Gundersen Lutheran, Ltd. LaCrosse, Wisconsin  54601