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关于年轻女性乳腺癌我们了解多少?

What Is Known about Breast Cancer in Young Women?

作者信息

Zhu Jie Wei, Charkhchi Parsa, Adekunte Shadia, Akbari Mohammad R

机构信息

Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5G 2C4, Canada.

Department of Medicine, University of Toronto, Toronto, ON M5S 1A1, Canada.

出版信息

Cancers (Basel). 2023 Mar 22;15(6):1917. doi: 10.3390/cancers15061917.

Abstract

Breast cancer (BC) is the second leading cause of cancer-related death in women under the age of 40 years worldwide. In addition, the incidence of breast cancer in young women (BCYW) has been rising. Young women are not the focus of screening programs and BC in younger women tends to be diagnosed in more advanced stages. Such patients have worse clinical outcomes and treatment complications compared to older patients. BCYW has been associated with distinct tumour biology that confers a worse prognosis, including poor tumour differentiation, increased Ki-67 expression, and more hormone-receptor negative tumours compared to women >50 years of age. Pathogenic variants in cancer predisposition genes such as BRCA1/2 are more common in early-onset BC compared to late-onset BC. Despite all these differences, BCYW remains poorly understood with a gap in research regarding the risk factors, diagnosis, prognosis, and treatment. Age-specific clinical characteristics or outcomes data for young women are lacking, and most of the standard treatments used in this subpopulation currently are derived from older patients. More age-specific clinical data and treatment options are required. In this review, we discuss the epidemiology, clinicopathologic characteristics, outcomes, treatments, and special considerations of breast cancer in young women. We also underline future directions and highlight areas that require more attention in future studies.

摘要

乳腺癌(BC)是全球40岁以下女性癌症相关死亡的第二大主要原因。此外,年轻女性乳腺癌(BCYW)的发病率一直在上升。年轻女性并非筛查项目的重点对象,且年轻女性的乳腺癌往往在更晚期才被诊断出来。与老年患者相比,这类患者的临床结局和治疗并发症更差。BCYW与独特的肿瘤生物学特性相关,这导致其预后更差,包括肿瘤分化不良、Ki-67表达增加,以及与50岁以上女性相比,激素受体阴性肿瘤更多。与晚发性乳腺癌相比,BRCA1/2等癌症易感基因的致病变异在早发性乳腺癌中更为常见。尽管存在所有这些差异,但人们对BCYW的了解仍然很少,在危险因素、诊断、预后和治疗方面的研究存在差距。缺乏针对年轻女性的特定年龄临床特征或结局数据,目前该亚组使用的大多数标准治疗方法都源自老年患者。需要更多针对特定年龄的临床数据和治疗选择。在本综述中,我们讨论了年轻女性乳腺癌的流行病学、临床病理特征、结局、治疗方法以及特殊注意事项。我们还强调了未来的方向,并突出了未来研究中需要更多关注的领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f22/10047861/214ee64246c6/cancers-15-01917-g002.jpg

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