Stibbards-Lyle Maya, Malinovska Julia, Badawy Seleem, Schedin Pepper, Rinker Kristina D
Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB, Canada.
Cellular and Molecular Bioengineering Research Lab, University of Calgary, Calgary, AB, Canada.
Front Oncol. 2024 May 21;14:1398196. doi: 10.3389/fonc.2024.1398196. eCollection 2024.
Young onset breast cancer (YOBC) is an increasing demographic with unique biology, limited screening, and poor outcomes. Further, women with postpartum breast cancers (PPBCs), cancers occurring up to 10 years after childbirth, have worse outcomes than other young breast cancer patients matched for tumor stage and subtype. Early-stage detection of YOBC is critical for improving outcomes. However, most young women (under 45) do not meet current age guidelines for routine mammographic screening and are thus an underserved population. Other challenges to early detection in this population include reduced performance of standard of care mammography and reduced awareness. Women often face significant barriers in accessing health care during the postpartum period and disadvantaged communities face compounding barriers due to systemic health care inequities. Blood tests and liquid biopsies targeting early detection may provide an attractive option to help address these challenges. Test development in this area includes understanding of the unique biology involved in YOBC and in particular PPBCs that tend to be more aggressive and deadly. In this review, we will present the status of breast cancer screening and detection in young women, provide a summary of some unique biological features of YOBC, and discuss the potential for blood tests and liquid biopsy platforms to address current shortcomings in timely, equitable detection.
年轻女性乳腺癌（YOBC）患者数量不断增加，其生物学特性独特，筛查受限，预后较差。此外，产后乳腺癌（PPBC）患者，即分娩后长达10年内发生癌症的患者，其预后比其他肿瘤分期和亚型匹配的年轻乳腺癌患者更差。早期发现YOBC对于改善预后至关重要。然而，大多数年轻女性（45岁以下）不符合当前常规乳腺钼靶筛查的年龄指导标准，因此是医疗服务不足的人群。该人群早期检测的其他挑战包括标准乳腺钼靶检查的效能降低以及意识淡薄。女性在产后时期获得医疗保健通常面临重大障碍，而弱势群体由于系统性医疗保健不平等面临更为复杂的障碍。针对早期检测的血液检测和液体活检可能提供一个有吸引力的选择，以帮助应对这些挑战。该领域的检测开发包括了解YOBC，特别是更具侵袭性和致命性的PPBC所涉及独特生物学特性。在本综述中，我们将介绍年轻女性乳腺癌筛查和检测的现状，总结YOBC的一些独特生物学特征，并讨论血液检测和液体活检平台解决当前及时、公平检测方面不足的潜力。
