TY - JOUR
T1 - Treatment of breast cancer in young women
T2 - Do we need more aggressive therapies?
AU - Cancello, Giuseppe
AU - Montagna, Emilia
PY - 2013
Y1 - 2013
N2 - Breast cancer diagnosed in young patients has been reported to have a more aggressive biologic behaviour and to be associated with a more unfavorable prognosis compared with the disease in older patients. However controversies exist regarding the optimal treatment and if more aggressive therapies are really crucial in this population. Very young women with this disease are faced with personal, family, professional, and quality-of-life issues that further complicate the phase of treatment decision-making. Moreover it's mandatory in young patients to consider the impact of acute but also late toxicities in relation to long life-expectancy, too. Dose-dense and high-dose chemotherapy are two examples of more aggressive therapies that failed to show a clear beneficial in a feasible way compared to standard regimens also in young patients. The benefit evidenced in patients with ER-positive disease raises the hypothesis that efficacy of dose-intensive chemotherapy might simply be related to its endocrine effects. The study of the biology and of the oncogenic pathways should be a research priority so to aid management of young patients with breast cancer, and more important, to better tailor treatments that could be offered to young women or, simply to use better the modalities available today. For the time being, young age alone should not be a reason to prescribe more aggressive therapies and there are no evidence to recommend a specific chemotherapy regimen for young women
AB - Breast cancer diagnosed in young patients has been reported to have a more aggressive biologic behaviour and to be associated with a more unfavorable prognosis compared with the disease in older patients. However controversies exist regarding the optimal treatment and if more aggressive therapies are really crucial in this population. Very young women with this disease are faced with personal, family, professional, and quality-of-life issues that further complicate the phase of treatment decision-making. Moreover it's mandatory in young patients to consider the impact of acute but also late toxicities in relation to long life-expectancy, too. Dose-dense and high-dose chemotherapy are two examples of more aggressive therapies that failed to show a clear beneficial in a feasible way compared to standard regimens also in young patients. The benefit evidenced in patients with ER-positive disease raises the hypothesis that efficacy of dose-intensive chemotherapy might simply be related to its endocrine effects. The study of the biology and of the oncogenic pathways should be a research priority so to aid management of young patients with breast cancer, and more important, to better tailor treatments that could be offered to young women or, simply to use better the modalities available today. For the time being, young age alone should not be a reason to prescribe more aggressive therapies and there are no evidence to recommend a specific chemotherapy regimen for young women
KW - Biology
KW - Breast cancer
KW - Chemotherapy
KW - Treatment
KW - Young
UR - http://www.scopus.com/inward/record.url?scp=84881511547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84881511547&partnerID=8YFLogxK
U2 - 10.3978/j.issn.2072-1439.2013.06.10
DO - 10.3978/j.issn.2072-1439.2013.06.10
M3 - Article
C2 - 23819027
AN - SCOPUS:84881511547
VL - 5
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
IS - SUPPL.1
ER -