Division of Medical Oncology, King Fahad Medical City, Comprehensive Cancer Centre, Riyadh, Saudi Arabia.
Curr Oncol. 2013 Feb;20(1):e34-9. doi: 10.3747/co.20.1131.
A 35-year-old recently married woman is referred to a surgeon because of a growing breast lump. After a core biopsy shows cancer, she undergoes mastectomy for a 6-cm invasive lobular cancer that has spread to 8 axillary nodes. By the time she sees the medical oncologist, she is told that it is too late for a fertility consultation, and she receives a course of chemotherapy. At clinic appointments, she seems depressed and admits that her husband has been less supportive than she had hoped. After tamoxifen is started, treatment-related sexuality problems and the probability of infertility contribute to increasing strain on the couple's relationship. Their marriage ends two years after the woman's diagnosis.Six years after her diagnosis, this woman has completed all treatment, is disease-free, and is feeling extremely well physically. However, she is upset about being postmenopausal, and she is having difficulty adopting a child as a single woman with a history of breast cancer. Could this woman and her husband have been offered additional personalized interventions that might have helped them better cope with the breast cancer diagnosis and the effects of treatment?Compared with their older counterparts, young women with breast cancer often have greater and more complex supportive care needs. The present article describes the goals, achievements, and future plans of a specialized interdisciplinary program-the first of its kind in Canada-for women 40 years of age and younger newly diagnosed with breast cancer. The program was created to optimize the complex clinical care and support needs of this population, to promote research specifically targeting issues unique to young women, and to educate the public and health care professionals about early detection of breast cancer in young women and about the special needs of those women after their diagnosis.
一位刚结婚不久的 35 岁女性,因乳房肿块而被转介给外科医生。在进行核心活检显示癌症后,她接受了乳房切除术,切除了 6 厘米的浸润性小叶癌,且已扩散到 8 个腋窝淋巴结。当她见到肿瘤内科医生时,被告知进行生育咨询为时已晚,她接受了一个疗程的化疗。在就诊时,她情绪低落,并承认丈夫的支持不如她所希望的那样。开始服用他莫昔芬后,与治疗相关的性功能问题和不孕的可能性增加了夫妻关系的压力。在这位女性被诊断出疾病两年后,他们的婚姻结束了。在被诊断出疾病六年后,这位女性已完成所有治疗,无疾病且身体状况极佳。然而,她对绝经感到不安,并且作为一名有乳腺癌病史的单身女性,她在领养孩子方面遇到了困难。这位女性和她的丈夫是否可以接受其他个性化干预措施,以帮助他们更好地应对乳腺癌诊断和治疗的影响?与年长的患者相比,年轻的乳腺癌患者通常有更多和更复杂的支持性护理需求。本文描述了一个专门的跨学科项目的目标、成就和未来计划,该项目是加拿大首个针对 40 岁及以下新诊断为乳腺癌的女性的项目。该项目旨在优化这一人群的复杂临床护理和支持需求,促进专门针对年轻女性特有问题的研究,并向公众和医疗保健专业人员宣传年轻女性乳腺癌的早期检测以及这些女性在诊断后的特殊需求。