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Breast cancer likely aggressive in young women

Pearl Toh
07 May 2019

Breast cancer in young women tends to be aggressive, according to a study presented at the ESMO Breast Cancer Congress (EBCC) 2019 in Berlin, Germany.

Nonetheless, young women with breast cancer can still achieve good outcomes if they receive appropriate guideline-recommended treatments, said ESMO spokesperson Dr Matteo Lambertini from IRCCS Policlinico San Martino Hospital in Genoa - University of Genoa in Genoa, Italy.

“It’s not true that being diagnosed with breast cancer at a young age means poorer survival or higher chances of the cancer coming back, and these studies further confirm that. Proper guideline-recommended treatments should be given to all breast cancer patients regardless of their age,” he urged. 

However, young age should not be a reason in itself for more intensive treatment, Lambertini highlighted.

In a retrospective multicentre study of 207 patients aged <35 years (median age 31 years) with breast cancer, ductal invasive carcinoma was the most common histologic subtype (91 percent). [EBCC 2019, abstract 101P_PR]

In terms of tumour subtypes, 28 percent were HER2 positive, 20 percent were triple negative, and 4 percent were luminal A vs 67 percent of luminal B subtypes, indicating that aggressive tumour subtypes are highly prevalent in these women, reported Dr Ines Eiriz of the Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal who presented the study during EBCC 2019. 

She also noted that locally advanced disease and de novo metastatic cancer were common among these patients, occurring at rates of 45 percent and 6 percent, respectively. 

Overall, 39 percent of patients were given neoadjuvant chemotherapy, out of which 12 percent showed a pathological complete response. Eighty-three percent of the patients received adjuvant systemic therapy in the form of chemotherapy or endocrine therapy, and 18 percent were exclusively treated with endocrine therapy.

Eighty-five percent of the patients were still alive after a median follow-up of 53.5 months. Three patients had a local recurrence while 26 developed metastases. “The median survival of patients without metastases was 130 months compared to 37 months for those with metastatic disease,” observed Eiriz.

“Disease-free survival was longest in women with hormone receptor positive tumours, followed by those with HER2 positive disease, and lastly those with triple negative breast cancer,” she said.

“Women under 40 years of age tend to be diagnosed with more aggressive breast cancer types – for example their tumours are more likely to be triple negative and HER2 positive. Despite this, survival and local recurrence rates are similar to those of the general population of breast cancer patients provided they receive appropriate treatment,” Lambertini said.

“Special attention should be paid in these women on the potential side effects of anticancer therapies including the risk of infertility,” he advised.  

 

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