Lee Han-Byoel, Han Wonshik
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. ; Cancer Research Institute, Seoul National University, Seoul, Korea.
J Breast Cancer. 2014 Dec;17(4):301-7. doi: 10.4048/jbc.2014.17.4.301. Epub 2014 Dec 26.
Young age breast cancer (YABC) has unique clinical and biological features that are not seen in older patients. Breast tumor biology is more aggressive and is associated with an unfavorable prognosis in younger women. The diagnosis of breast cancer is often delayed, resulting in their initial presentation with more advanced disease. Together, these characteristics lead to a poorer prognosis in younger women than in older women. Young women who receive breast-conserving therapy have a higher rate of local recurrence. Therefore, it is important to secure sufficient resection margins and consider boost radiotherapy to prevent local treatment failure. Based on age alone, patients with YABC should be regarded as high-risk cases, and they should be treated with adjuvant chemotherapy. Special considerations regarding psychosocial factors and fertility should be taken into account for young patients. This review discusses the major considerations and principles concerning the management of patients with YABC.
年轻乳腺癌(YABC)具有一些老年患者所没有的独特临床和生物学特征。乳腺肿瘤生物学行为更具侵袭性,且与年轻女性预后不良相关。乳腺癌的诊断往往延迟,导致她们初次就诊时病情更晚。这些特征共同导致年轻女性的预后比老年女性更差。接受保乳治疗的年轻女性局部复发率更高。因此,确保足够的切缘并考虑追加放疗以防止局部治疗失败很重要。仅基于年龄,YABC患者就应被视为高危病例,应接受辅助化疗。对于年轻患者,应考虑心理社会因素和生育方面的特殊问题。本综述讨论了YABC患者管理的主要注意事项和原则。