Department of Obstetrics and Gynecology, University of Rostock, Südring 81, Rostock, Germany.
Clin Breast Cancer. 2011 Aug;11(4):196-203. doi: 10.1016/j.clbc.2011.06.001. Epub 2011 Jul 12.
To give an overview about current treatment recommendations and special problems concerning the management of women <35 years with early breast cancer.
We performed a selective systematic literature review. We discussed with reference to key studies and meta-analyses, current standards of care, and controversies regarding patient management.
Breast cancer in patients younger than 35 years is rare but associated with an unsatisfactory prognosis. Local treatment should not differ from general guidelines, but awareness of the high risk of local recurrence must be maintained. Adjuvant polychemotherapy is almost always indicated, standard endocrine therapy is tamoxifen. Before the start of systemic therapy, the patient must be offered different types of fertility preservation. Pregnancy related breast cancer is not associated with a worse prognosis, but with delayed diagnosis. Therefore, every suspicious lesion in the breast or axilla must be imaged and biopsied. The optimal time to delay pregnancy following the diagnosis is unknown. Hormonal contraceptives are contraindicated after breast cancer. Every woman <35 years diagnosed with breast cancer should be offered genetic counseling.
The management of breast cancer in very young women requires a multidisciplinary team to find the optimal treatment and to solve their specific problems.
为了概述 35 岁以下早期乳腺癌女性患者的治疗建议和特殊管理问题。
我们进行了选择性的系统文献回顾。我们参照关键研究和荟萃分析、当前的治疗标准以及关于患者管理的争议进行了讨论。
35 岁以下患者的乳腺癌较为罕见，但预后较差。局部治疗不应与一般指南有差异，但必须注意局部复发的高风险。辅助化疗几乎总是有指征的，标准内分泌治疗是他莫昔芬。在开始全身治疗之前，必须为患者提供不同类型的生育力保存。妊娠相关性乳腺癌与预后较差无关，但诊断延迟。因此，乳房或腋窝的每个可疑病变都必须进行影像学检查和活检。诊断后延迟妊娠的最佳时间尚不清楚。乳腺癌后禁用激素避孕药。每个诊断为乳腺癌的<35 岁女性都应提供遗传咨询。
年轻女性乳腺癌的管理需要多学科团队来找到最佳治疗方法并解决其特殊问题。
