Skip to main content

Advertisement

SpringerLink
Log in

Diagnosis and Treatment of Breast Cancer in Young Women

  • Breast Cancer (EA Comen, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

Despite the increase of breast cancer incidence with age, approximately 7 to 10% ofwomen diagnosed with breast cancer are younger than the age 40. This subgroup ofpatients has different risk factors, tumour biology, clinical outcomes, and specific psy- chosocial issues, such as fertility preservation, family planning, and job reintegration. However, age alone should not be the main consideration when choosing the aggressive- ness of the treatment, as other factors must be considered, including the biologic aggressiveness of the tumour, potential long-term toxicities, and the preferences of the patient. Fertility preservation techniques should be discussed with the patient before starting any cancer treatment. Despite the significant percentage of breast cancer patients younger than age 40, fewclinical studies have specifically investigated disease characteristics and outcomes of this population, and most therapies routinely administered to these younger women were tested in older patients. Moreover, young women who have breast cancer are at a greater risk of sexual and psychological distress, and clinicians should address these issues in order to properly support patients during the long diagnostic and therapeutic journey. Consequently, it is essential to follow diagnostic and treatment guidelines specificallyaddressed to young women. Additional specific procedures should be followed to treat pregnant patients with breast cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29.

    PubMed  Google Scholar 

  2. Ferlay J, Soerjomataram I, and Ervik M, et al.GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC cancer-Base No. 11, 2013 [Lyon, France: International Agency for Research on cancer]. [http://globocan.iarc.fr/].

  3. Villarreal-Garza C, Aguila C, Magallanes-Hoyos MC, Mohar A, Bargalló E, Meneses A, et al. Breast cancer in young women in Latin America: an unmet, growing burden. Oncologist. 2013;18(12):1298–306. https://doi.org/10.1634/theoncologist.2013-0321.

    PubMed  PubMed Central  Google Scholar 

  4. National Cancer Institute - Surveillance, Epidemiology and End Results Program. http://seer.cancer.gov/statfacts/html/breast.html. Accessed 7 May 2017

  5. Nixon AJ, Neuberg D, Hayes DF, Gelman R, Connolly JL, Schnitt S, et al. Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer. J Clin Oncol. 1994;12:888–94.

    CAS  PubMed  Google Scholar 

  6. Ruddy KJ, Gelber S, Tamimi RM, Schapira L, Come SE, Meyer ME, et al. Breast cancer presentation and diagnostic delays in young women. Cancer. 2014;120(1):20–5. https://doi.org/10.1002/cncr.28287.

    Article  PubMed  Google Scholar 

  7. Winchester DP, Osteen RT, Menck HR. The National Cancer Data Base report on breast carcinoma characteristics and outcome in relation to age. Cancer. 1996;78:1838–43.

    CAS  PubMed  Google Scholar 

  8. Azim HA, Partridge AH. Biology of breast cancer in young women. Breast Cancer Res. 2014;16:427.

    PubMed  PubMed Central  Google Scholar 

  9. Lambertini M, Pinto AC, Ameye L, Jongen L, del Mastro L, Puglisi F, et al. The prognostic performance of adjuvant! Online and Nottingham prognostic index in young breast cancer patients. Br J Cancer. 2016;115:1471–8.

    PubMed  PubMed Central  Google Scholar 

  10. Anders CK, Hsu DS, Broadwater G, Acharya CR, Foekens JA, Zhang Y, et al. Young age at diagnosis correlates with worse prognosis and defines a subset of breast cancers with shared patterns of gene expression. J Clin Oncol. 2008;26(20):3324–30. https://doi.org/10.1200/JCO.2007.14.2471.

    Article  PubMed  Google Scholar 

  11. Wang MX, Ren JT, Tang LY, et al. Molecular features in young vs elderly breast cancer patients and the impacts on survival disparities by age at diagnosis. Cancer Med. 2018;7(7):3269–77.

    CAS  PubMed Central  Google Scholar 

  12. Azim HA, Nguyen B, Brohée S, et al. Genomic aberrations in young and elderly breast cancer patients. BMC Med. 2015;13:266.

    PubMed  PubMed Central  Google Scholar 

  13. Anders CK, Fan C, Parker JS, Carey LA, Blackwell KL, Klauber-DeMore N, et al. Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes? J Clin Oncol. 2011;29:e18–20.

    PubMed  Google Scholar 

  14. Malone KE, Daling JR, Neal C, Suter NM, O’Brien C, Cushing-Haugen K, et al. Frequency of BRCA1/BRCA2 mutations in a population-based sample of young breast carcinoma cases. Cancer. 2000;88:1393–402.

    CAS  PubMed  Google Scholar 

  15. Lakhani SR, Van De Vijver MJ, Jacquemier J, et al. The pathology of familial breast cancer: predictive value of immunohistochemical markers estrogen receptor, progesterone receptor, HER-2, and p53 in patients with mutations in BRCA1 and BRCA2. J Clin Oncol. 2002;20:2310–8.

    CAS  PubMed  Google Scholar 

  16. Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL, et al. Average risk of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 2003;72:1117–30.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Cavanagh H, Rogers KM. The role of BRCA1 and BRCA2 mutations in prostate, pancreatic and stomach cancers. Hereditary Cancer in Clinical Practice. 2015;13(1):16.

    PubMed  PubMed Central  Google Scholar 

  18. Li FP, Fraumeni JF Jr, Mulvihill JJ, et al. A Cancer family syndrome in twenty-four kindreds. Cancer Res. 1988;48:5358–62.

    CAS  PubMed  Google Scholar 

  19. Li FP, Fraumeni JF Jr. Soft-tissue sarcomas, breast cancer, and other neoplasms. A familial syndrome? Ann Inter Med. 1969;71:747–53.

    CAS  Google Scholar 

  20. Garber JE, Goldstein AM, Kantor AF, Dreyfus MG, Fraumeni JF Jr, Li FP. Follow-up study fo twenty-four families with Li-Fraumeni syndrome. Cancer Res. 1991;51:6094–7.

    CAS  PubMed  Google Scholar 

  21. Varley JM, McGrown G, Thorncroft M, et al. Germ-line mutations of TP53 in Li-Fraumeni families: an extended study of 39 familes. Cancer Res. 1997;57:3245–52.

    CAS  PubMed  Google Scholar 

  22. Chompret A, Abel A, Stoppa-Lyonnet D, Brugiéres L, Pagés S, Feunteun J, et al. Sensitivity and predictive value of criteria for p53 germline mutation screening. J Med Genet. 2001;38:43–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Chompret A, Brugières L, Ronsin M, Gardes M, Dessarps-Freichey F, Abel A, et al. p53 germline mutations in childhood cancers and cancer risk for carrier individuals. Br J Cancer. 2000;82:1932–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Easton DF, Pharoah PD, Antoniou AC, Tischkowitz M, Tavtigian SV, Nathanson KL, et al. Gene-panel sequencing and the prediction of breast-cancer risk. N Engl J Med. 2015 Jun 4;372(23):2243–57.

    CAS  PubMed  Google Scholar 

  25. Mandelson MT, Oestreicher N, Porter PL, White D, Finder CA, Taplin SH, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. J Natl Cancer Inst. 2000;92:1081–7.

    CAS  PubMed  Google Scholar 

  26. Foxcroft LM, Evans EB, Porter AJ. The diagnosis of breast cancer in women younger than 40. Breast. 2004;13:297–306.

    CAS  PubMed  Google Scholar 

  27. Saslow D, Boetes C, Burke W, Harms S, Leach MO, Lehman CD, et al. American Cancer Society Breast Cancer Advisory Group: American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.

    PubMed  Google Scholar 

  28. Pediconi F, Catalano C, Roselli A, Dominelli V, Cagioli S, Karatasiou A, et al. The challenge of imaging dense breast parenchyma: is magnetic resonance mammography the technique of choice? A comparative study with x-ray mammography and whole-breast ultrasound. Investig Radiol. 2009;44:412–21.

    Google Scholar 

  29. •• Paluch-Shimon S, Pagani O, Partridge AH, et al. ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3). Breast, 2017;35:203–217. These are the most recent guidelines specifically focused on treating young women with breast cancer.

  30. van Nes JGH, van de Velde CJH. The preferred treatment for young women with breast cancer—mastectomy versus breast conservation. Breast. 2006;15(S2):S3–S10.

    PubMed  Google Scholar 

  31. King TA. Selecting local therapy in the young breast cancer patient. J Surg Oncol. 2011;103(4):330–6.

    PubMed  Google Scholar 

  32. Freedman GM, Hanlon AL, Fowble BL, Anderson PR, Nicolaou N. Recursive partitioning identifies patients at high and low risk for ipsilateral tumor recurrence after breast-conserving surgery and radiation. J Clin Oncol. 2002;20:4015–21.

    CAS  PubMed  Google Scholar 

  33. • Hickey, BE, James ML, Lehman M et al. Fraction size in radiation therapy for breast conservation in early breast cancer. Cochrane Database Syst, 2016; Rev. 18 (July (7)), CD003860. It is a large systematic review of the role of hypofractionated radiotherapy after conservative breast surgery. Young patients are included in the analysis.

  34. • Balic M, Thommsen C, Wüstlein R et al. St. Gallen/Vienna 2019: a brief summary of the consensus discussion on the optimal primary breast cancer treatment. Breast Care, 2019;14:103–110. It is a brief summary of the recent guidelines from the 16th St Gallen Consensus Conference on the treatment of early breast cancer.

    PubMed  Google Scholar 

  35. Meattini I, Lambertini M, Desideri I, et al. Radiation therapy for young women with early breast cancer: current state of the art. Crit Rev Oncol Hematol. 2019;137:143–53.

    PubMed  Google Scholar 

  36. Healey EA, Cook EF, Orav EJ, Schnitt SJ, Connolly JL, Harris JR. Contralateral breast cancer: clinical characteristics and impact on prognosis. J Clin Oncol. 1993;11:1545–52.

    CAS  PubMed  Google Scholar 

  37. Rosen PP, Groshen S, Kinne DW, Hellman S. Contralateral breast carcinoma: an assessment of risk and prognosis in stage I (T1N0M0) and stage II (T1N1M0) patients with 20-year follow-up. Surgery. 1989;106:904–10.

    CAS  PubMed  Google Scholar 

  38. McDonnell SK, Schaid DJ, Myers JL, Grant CS, Donohue JH, Woods JE, et al. Efficacy of contralateral prophylactic mastectomy in women with a personal and family history of breast cancer. J Clin Oncol. 2001;19:3938–43.

    CAS  PubMed  Google Scholar 

  39. Herrinton LJ, Barlow WE, Yu O, Geiger AM, Elmore JG, Barton MB, et al. Efficacy of prophylactic mastectomy in women with unilateral breast cancer: a cancer research network project. J Clin Oncol. 2005;23:4275–86.

    PubMed  Google Scholar 

  40. Arrington AK, Jarosek SL, Virnig BA, Habermann EB, Tuttle TM. Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Ann Surg Oncol. 2009;16:2697–704.

    PubMed  Google Scholar 

  41. Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol. 2007;25:5203–9.

    PubMed  Google Scholar 

  42. Bedrosian I, Hu CY, Chang GJ. Population-based study of contralateral prophylactic mastectomy and survival outcomes of breast cancer patients. J Natl Cancer Inst. 2010;102:401–9.

    PubMed  PubMed Central  Google Scholar 

  43. • Sparano JA, Gray RJ, Makower DF et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med, 2018; 379:111–121. It is a large trial comparing chemotherapy and endocrine therapy versus endocrine therapy alone in patients who have luminal HER2-negative breast cancer and an intermediate risk score on Oncotype DX. The results of this trial show that most of these patients do not need chemotherapy after surgery.

  44. Dowsett M, Folkerd E, Doody D, Haynes B. The biology of steroid hormones and endocrine treatment of breast cancer. Breast. 2005;14:452–7.

    PubMed  Google Scholar 

  45. Rossi L, Pagani O. The modern landscape of endocrine therapy for premenopausal women with breast cancer. Breast Care (Basel). 2015;10(5):312–5.

    Google Scholar 

  46. Rossi L, Pagani O. Adjuvant endocrine therapy in breast cancer: evolving paradigms in premenopausal women. Curr Treat Options in Oncol. 2017;18(5):28.

    Google Scholar 

  47. Pagani O, Regan MM, Walley BA, Fleming GF, Colleoni M, Láng I, et al. Adjuvant exemestane with ovarian suppression in premenopausal breast cancer. N Engl J Med. 2014;371:107–18.

    PubMed  PubMed Central  Google Scholar 

  48. Francis P, Meredith M, Fleming GF, et al. Adjuvant ovarian suppression in premenopausal breast cancer. N Engl J Med. 2015;372:436–46.

    PubMed  Google Scholar 

  49. • Francis PA, Pagani O, Fleming GF et al. Tailoring adjuvant endocrine therapy for premenopausal breast cancer. N Engl J Med, 2018; 379:122–137. It is an updated report of the results from the SOFT and TEXT trials, with significant results on the 8-year rate of overall survival.

  50. • Regan MM, FLemin GF, Walley B et al. Adjuvant systemic treatment of premenopausal women with hormone receptor–positive early breast cancer: lights and shadows. J Clin Oncol, 2019; 37(11): 862–867. In this editorial, the authors interestingly focus on some advantages and limitations of the SOFT and TEXT trials.

    CAS  PubMed  Google Scholar 

  51. • Curigliano G, Burstein HJ, Winer EP et al. De-escalating and escalating treatments for early-stage breast cancer: the St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann Oncol, 2017; 28: 1700–1712. This discusses the updated international guidelines on the treatment of early breast cancer based on the panel of the St Gallen Internation Expert Consensus Conference in 2017.

  52. • Burstein HJ, Lacchetti C, Anderson H et al. Adjuvant endocrine therapy for women with hormone receptor–positive breast cancer: ASCO clinical practice guideline focused update. Journal of Clinical Oncology 2019 37:5, 423-438. This discusses the updtated international guidelines on the treatment of early breast cancer based on the panel of American Society of Clinical Oncology (ASCO) in 2018.

  53. Regan MM, Walley BA, Francis PA, Fleming GF, Láng I, Gómez HL, et al. Concurrent and sequential initiation of ovarian function suppression with chemotherapy in premenopausal women with endocrine-responsive early breast cancer: an exploratory analysis of TEXT and SOFT. Ann Oncol. 2017 Sep 1;28(9):2225–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  54. Bellet M, Gray KP, Francis PA, Láng I, Ciruelos E, Lluch A, et al. Twelve-month estrogen levels in premenopausal women with hormone receptor-positive breast cancer receiving adjuvant triptorelin plus exemestane or tamoxifen in the Suppression of Ovarian Function Trial (SOFT): the SOFT-EST Substudy. J Clin Oncol. 2016;34:1584–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Bellet M, Gray K, Francis P et al. Estrogen levels in premenopausal patients (pts) with hormone-receptor positive (HR+) early breast cancer (BC) receiving adjuvant triptorelin (Trip) plus exemestane (E) or tamoxifen (T) in the SOFT trial: SOFT-EST substudy final analysis [abstract]. In: San Antonio Breast Cancer Symposium 2018, December 4–8, 2018, Texas, USA.

  56. • H. Pan, R. Gray, J. Braybrooke, et al., 20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years, N Engl J Med 377 (2017) 1836–1846. This is an extensive meta-analysis on the risk of late-relapse until 20 years of follow-up.

    PubMed  Google Scholar 

  57. Rossi L, McCartney A, De Santo I, et al. The optimal duration of adjuvant endocrine therapy in early luminal breast cancer: a concise review. Cancer Treat Rev. 2019;74:29–34.

    PubMed  Google Scholar 

  58. Davies C, Pan H, Godwin J, Gray R, Arriagada R, Raina V, et al. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial. Lancet. 2013;381:805–16.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Gray RG, Rea D, Handley K et al. aTTom: long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years in 6,953 women with early breast cancer. J. Clin. Oncol, 2013; 31(Suppl.), Abstract 5.

    Google Scholar 

  60. Senkus E, Kyriakides S, Ohno S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2015 Sep;26(Suppl 5):v8–30.

    PubMed  Google Scholar 

  61. Coates AS, Winer EP, Goldhirsch A, et al. Tailoring therapies-improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015. Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2015;26:1533–46.

    CAS  Google Scholar 

  62. Paluch-Shimon S, Pagani O, Partridge AH, et al. Second international consensus guidelines for breast cancer in young women (BCY2). Breast. 2016;26:87–99.

    PubMed  Google Scholar 

  63. Allred DC, Anderson SJ, Paik S, Wickerham DL, Nagtegaal ID, Swain SM, et al. Adjuvant tamoxifen reduces subsequent breast cancer in women with estrogen receptor-positive ductal carcinoma in situ: a study based on NSABP protocol B-24. J Clin Oncol. 2012;30(12):1268–73.

    CAS  PubMed  PubMed Central  Google Scholar 

  64. King MC, Wieand S, Hale K, Lee M, Walsh T, Owens K, et al. Tamoxifen and breast cancer incidence among women with inherited mutations in BRCA1 and BRCA2: National Surgical Adjuvant Breast and Bowel Project (NSABP-P1) Breast Cancer Prevention Trial. JAMA. 2001;286(18):2251–6.

    CAS  PubMed  Google Scholar 

  65. De Censi A, Puntoni M, Gonzaga AG, et al. Randomized trial of low dose tamoxifen to prevent recurrence of breast intraepithelial neoplasia. Presented at: 41st Annual San Antonio Breast Cancer Symposium; December 4–8, 2018; San Antonio, Texas. Abstract GS03-01.

  66. Chirgwin JH, Giobbie-Hurder A, Coates AS, Price KN, Ejlertsen B, Debled M, et al. Treatment adherence and its impact on disease-free survival in the Breast International Group 1-98 trial of tamoxifen and letrozole, alone and in sequence. J Clin Oncol. 2016;34(21):2452–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Hershman DL, Kushi LH, Shao T, Buono D, Kershenbaum A, Tsai WY, et al. Early discontinuation and nonadherence to adjuvant hormonal therapy in a cohort of 8,769 early-stage breast cancer patients. J Clin Oncol. 2010;28(27):4120–8.

    PubMed  PubMed Central  Google Scholar 

  68. Cardoso F, Costa A, Papadopoulos E, et al. 4th ESO–ESMO international consensus guidelines for advanced breast cancer (ABC 4). Ann Oncol. 2018;29:1634–57.

    CAS  PubMed  Google Scholar 

  69. Rossi L, Pagani O. Impact of breast Cancer treatment on fertility, chapter on Biglia N, Peccatori F. Breast Cancer, Fertility Preservation and Reproduction. Springer International Publishing, 2015. DOI: https://doi.org/10.1007/978-3-319-17278-1.

    Google Scholar 

  70. Trefoux-Bourdet A, Reynaud-Bougnoux A, Body G et al. Pregnancy after breast cancer: a literature review. Presse Med. 2019 Mar 26. pii: S0755–4982(19)30049–1. doi: https://doi.org/10.1016/j.lpm.2019.01.011.

    PubMed  Google Scholar 

  71. Lambertini M, Kroman N, Ameye L, et al. Long-term safety of pregnancy following breast cancer according to estrogen receptor status. J Natl Cancer Inst. 2018 Apr 1;110(4):426–9.

    PubMed Central  Google Scholar 

  72. De Simone V, Pagani O. Pregnancy after breast cancer: hope after the storm. Minerva Ginecol. 2017;69(6):597–607.

    Google Scholar 

  73. Lambertini M, Di Maio M, Pagani O, et al. The BCY3/BCC 2017 survey on physicians’ knowledge, attitudes and practice towards fertility and pregnancy-related issues in young breast cancer patients. Breast. 2018;42:41–9.

    PubMed  Google Scholar 

  74. Loren AW, Mangu PB, Beck LN, Brennan L, Magdalinski AJ, Partridge AH, et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:2500–10.

    PubMed  PubMed Central  Google Scholar 

  75. Peccatori FA, Azim HA Jr, Orecchia R, et al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2013;24 Suppl 6:vi160–70.

    PubMed  Google Scholar 

  76. Lambertini M, Del Mastro L, Pescio MC et al. Cancer and fertility preservation: international recommendations from an expert meeting. BMC Med. 2016; 14: 1.

  77. Lambertini M, Moore HCF, Leonard RCF, Loibl S, Munster P, Bruzzone M, et al. Gonadotropin-releasing hormone agonists during chemotherapy for preservation of ovarian function and fertility in premenopausal patients with early breast cancer: a systematic review and meta-analysis of individual patient–level data. J Clin Oncol. 2018 Jul 1;36(19):1981–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Goldrat O, Kroman N, Peccatori FA, Cordoba O, Pistilli B, Lidegaard O, et al. Pregnancy following breast cancer using assisted reproduction and its effect on long-term outcome. Eur J Cancer. 2015 Aug;51(12):1490–6.

    PubMed  Google Scholar 

  79. Munoz E, Gonzàlez N, Munoz L, et al. Ovarian stimulation in patients with breast cancer. Ecancermedicalscience. 2015;9:504.

    PubMed  PubMed Central  Google Scholar 

  80. Sooyoung K, Younji L, Sanghoon L, et al. Ovarian tissue cryopreservation and transplantation in patients with cancer. Obstet Gynecol Sci. 2018 Jul;61(4):431–42.

    Google Scholar 

  81. Biglia N, Torrisi R, D’Alonzo M, et al. Attitudes on fertility issues in breast cancer patients: an Italian survey. Gynecol Endocrinol. 2015;3(1):458–64.

    Google Scholar 

  82. Lambertini M, Goldrat O, Barragan-Carrillo R, Viglietti G, Demeestere I, Villarreal-Garza C. Viable options for fertility preservation in breast cancer patients: a focus on Latin America. Rev Investig Clin. 2017;69:103–13.

    CAS  Google Scholar 

  83. Middleton LP, Amin M, Gwyn K, Theriault R, Sahin A. Breast carcinoma in pregnant women. Assessment of clinicopathological and immunohitochemical features. Cancer. 2003;98:1055–60.

    PubMed  Google Scholar 

  84. Bae SY, Jung SP, Jung ES, Park SM, Lee SK, Yu JH, et al. Clinical characteristics and prognosis of pregnancy-associated breast cancer: poor survival of luminal B subtype. Oncology. 2018;95(3):163–9.

    CAS  PubMed  Google Scholar 

  85. Ulery M, Carter L, McFarlin BL et al. Pregnancy-associated breast cancer: significance of early detection.J Midwifery Womens Health2009;54: 357–363.

    Google Scholar 

  86. Van Hasselt JGC, van Calsteren K, Heyns L, Han S, Mhallem Gziri M, Schellens JH, et al. Optimizing anticancer drug treatment in pregnant cancer patients: pharmacokinetic analysis of gestation-induced changes for doxorubicin, epirubicin, docetaxel and paclitaxel. Ann Oncol. 2014;25:2059–65.

    PubMed  Google Scholar 

  87. Woo JC, Yu T, Hurd TC. Breast cancer in pregnancy: a literature review. Arch Surg. 2003;138(1):91–9.

    PubMed  Google Scholar 

  88. Loibl S, Han SN, von Minckwitz G, Bontenbal M, Ring A, Giermek J, et al. Treatment of breast cancer during pregnancy: an observational study. Lancet Oncol. 2012;13(9):887–96.

    CAS  PubMed  Google Scholar 

  89. Amant F, Van Calsteren K, Halaska MJ, Gziri MM, Hui W, Lagae L, et al. Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study. Lancet Oncol. 2012;13:256–64.

    CAS  PubMed  Google Scholar 

  90. Kai S, Kohmura H, Hiraiwa E, et al. Reproductive and developmental toxicity studies of paclitaxel. (II)--Intravenous administration to rats during the fetal organogenesis. J Toxicol Sci. 1994 Aug;19 Suppl 1:69–91.

    CAS  PubMed  Google Scholar 

  91. Anderson GD. Pregnancy-induced changes in pharmacokinetics: a mechanistic-based approach. Clin Pharmacokinet. 2005;44:989–1008.

    CAS  PubMed  Google Scholar 

  92. Zagouri F, Sergenanis TN, Chrysikos D, et al. Taxanes for breast cancer during pregnancy: a systematic review. Clin Breast Cancer. 2013;13(1):16–23.

    CAS  PubMed  Google Scholar 

  93. Gucalp R, Knight R. Pamidronate for cancer-associated hypercalcemia—reply. Arch Intern Med. 1995;155:642–5.

    Google Scholar 

  94. Cuvier C, Espie M, Extra JM, Marty M. Vinorelbine in pregnancy. Eur J Cancer. 1997;33(1):168–9.

    CAS  PubMed  Google Scholar 

  95. Cullins SL, Pridjian G, Sutherland CM. Goldenhar’s syndrome associated with tamoxifen given to the mother during gestation. JAMA. 1994;271(24):1905–6.

    CAS  PubMed  Google Scholar 

  96. Berger JC, Clericuzio CL. Pierre Robin sequence associated with first trimester fetal tamoxifen exposure. Am J Med Genet A. 2008;146A(16):2141–4.

    PubMed  Google Scholar 

  97. Tewari K, Bonebrake RG, Asrat T, Shanberg AM. Ambiguous genitalia in infant exposed to tamoxifen in utero. Lancet. 1997;350(9072):183.

    CAS  PubMed  Google Scholar 

  98. Waterston AM, Graham J. Effect of adjuvant trastuzumab on pregnancy. J Clin Oncol. 2006;24(2):321–2.

    PubMed  Google Scholar 

  99. Pant S, Landon MB, Blumenfeld M, et al. Treatment of breast cancer with trastuzumab during pregnancy. J Clin Oncol. 2008;26(9):1567–9.

    PubMed  Google Scholar 

  100. Kelly H, Graham M, Humes E, Dorflinger LJ, Boggess KA, O’Neil BH, et al. Delivery of a healthy baby after first-trimester maternal exposure to lapatinib. Clin Breast Cancer. 2006;7:339–41.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Oncology of Southern Switzerland (IOSI), Bellinzona, Switzerland

    Lorenzo Rossi MD, Calogero Mazzara MD & Olivia Pagani MD

  2. Breast Unit of Southern Switzerland (CSSI), Lugano, Switzerland

    Lorenzo Rossi MD, Calogero Mazzara MD & Olivia Pagani MD

Authors
  1. Lorenzo Rossi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calogero Mazzara MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olivia Pagani MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lorenzo Rossi MD.

Ethics declarations

Conflict of Interest

Lorenzo Rossi, Calogero Mazzara, and Olivia Pagani declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors..

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Breast Cancer

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rossi, L., Mazzara, C. & Pagani, O. Diagnosis and Treatment of Breast Cancer in Young Women. Curr. Treat. Options in Oncol. 20, 86 (2019). https://doi.org/10.1007/s11864-019-0685-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11864-019-0685-7

Keywords

Search

Navigation