Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain; Department of Medical Oncology, Pontificia Universidad Catolica de Chile, Santiago, Chile; Faculty of Medicine, Universidad Catolica de Chile, Santiago, Chile.
Translational Genomics and Targeted Therapies in Solid Tumors Group, August Pi I Sunyer Biomedical Research Institute, Barcelona, Spain; Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain.
Cancer Treat Rev. 2024 Sep;129:102804. doi: 10.1016/j.ctrv.2024.102804. Epub 2024 Jul 14.
The incidence of breast cancer in ≤ 40 yr-old women (YWBC) has been steadily increasing in recent decades. Although this group of patients represents less than 10 % of all newly diagnosed BC cases it encompasses a significant burden of disease. Usually underrepresented in clinical trials, YWBCs are also characterized by late diagnoses and poorly differentiated, aggressive-subtype disease, partly explaining its poor prognosis along with a high recurrence risk, and high mortality rates. On the other hand, YWBC treatment poses unique challenges such as preservation of fertility, and long-term toxicity and adverse events. Herein, we summarize the current evidence in hormone receptor-positive YWBC including specific risk factors, clinicopathologic and genomic features, and available evidence on response to chemotherapy and endocrine therapy. Overall, we advocate for a more comprehensive multidisciplinary healthcare model to improve the outcomes and the quality of life of this subset of younger patients.
近年来，≤40 岁女性（年轻乳腺癌患者，YWBC）的乳腺癌发病率一直在稳步上升。尽管这组患者在所有新诊断的乳腺癌病例中不到 10%，但她们承担着相当大的疾病负担。YWBC 通常在临床试验中代表性不足，其特点还包括诊断较晚、分化差、侵袭性亚型疾病，这在一定程度上解释了其预后不良、复发风险高和死亡率高的原因。另一方面，YWBC 的治疗也带来了独特的挑战，如生育力的保留，以及长期的毒性和不良事件。本文总结了激素受体阳性 YWBC 的现有证据，包括特定的危险因素、临床病理和基因组特征，以及对化疗和内分泌治疗反应的现有证据。总之，我们提倡建立一个更全面的多学科医疗保健模式，以改善这一年轻患者亚组的结局和生活质量。
