Tailored therapy for breast cancer in very young women

Abstract

The heterogeneity of breast cancer is well understood both biologically and in the practice setting. On one hand, it is not uncommon for some patients to survive for years despite the presence of widely advanced or metastatic disease. In contrast, patients with localized tumors may relapse rapidly despite adequate surgical and medical treatment. Age has long been considered to have a strong association with this varying clinical behavior, with older patients being more likely to have indolent disease, and younger patients tending to have a more aggressive course. Recognizing the unique nature of the disease in this younger population, in 1993 the National Institutes of Health (NIH) sponsored a conference to discuss the various aspects of breast cancer in younger women. The consensus statements were published in the Journal of the National Cancer Institute Monographs [99]. Since then, multiple consensus panels have acknowledged young age as an adverse prognostic factor [29, 43, 45], although controversy regarding treatment still exists. Thus, it is appropriate to consider the special scenario of breast cancer in the young, premenopausal patient, with a specific focus on whether therapy should be tailored in a different manner than in older premenopausal or postmenopausal patients. © Springer-Verlag Berlin Heidelberg 2006.