Womens College Research Institute, 790 Bay Street, Toronto, ON M5G 1N8, Canada.
Nat Rev Clin Oncol. 2012 Jun 26;9(8):460-70. doi: 10.1038/nrclinonc.2012.102.
About one in 300 women will be diagnosed with breast cancer before the age of 40. Advances in screening have not had an impact on mortality in women who are too young to be candidates for screening. Risk factors for early breast cancer include a lean body habitus and recent use of an oral contraceptive. Breast cancers in very young women are typically aggressive, in part owing to the over-representation of high-grade, triple-negative tumours, but young age is an independent negative predictor of cancer-specific survival. Very early age-of-onset also correlates strongly with the risk of local recurrence and with the odds of contralateral breast cancer. Given the high risks of local and distant recurrence in young women with invasive breast cancer, most (if not all) young patients are candidates for chemotherapy. It is hoped that by increasing breast cancer awareness, the proportion of invasive breast cancers that are diagnosed at 2.0 cm or smaller will increase and that this will lead to a reduction in mortality.
大约每 300 名女性中就有 1 人会在 40 岁之前被诊断出患有乳腺癌。虽然筛查技术有所进步，但对于年龄太小而不能进行筛查的女性来说，这并没有对死亡率产生影响。早期乳腺癌的风险因素包括偏瘦的体型和近期使用口服避孕药。非常年轻的女性的乳腺癌通常更具侵袭性，部分原因是高级别、三阴性肿瘤的比例过高，但年轻是癌症特异性生存的独立负预测因素。发病年龄很早与局部复发风险和对侧乳腺癌的几率也密切相关。鉴于年轻女性浸润性乳腺癌局部和远处复发的风险很高，大多数（如果不是全部）年轻患者都适合化疗。人们希望通过提高对乳腺癌的认识，将诊断为 2.0 厘米或更小的浸润性乳腺癌的比例增加，并由此降低死亡率。
