Prospective Observational Study of Breast Cancer Treatment Outcomes for UK Women Aged 18–40 Years at Diagnosis: The POSH Study

Copson, Ellen; Eccles, Bryony; Maishman, Tom; Gerty, Sue; Stanton, Louise; Cutress, Ramsey I.; Altman, Douglas G.; Durcan, Lorraine; Simmonds, Peter; Lawrence, Gill; Jones, Louise; Bliss, Judith; Eccles, Diana M.

doi:10.1093/jnci/djt134

Cited by 167 publications

(141 citation statements)

References 36 publications

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“…HER2 overexpression was observed in 24% of the tumors and estrogen receptors were found in 66% of the cases. Triple-negative (lack of ER, PR expression, and HER2 overexpression) tumors were detected in 19.9% of the patients [14]. In another study, triple-negative cancers were found in 26% of the affected women and HER2 overexpression in 34% of women aged ≤ 40 [15].…”

Section: Tumor Biologymentioning

confidence: 92%

Breast cancer in young women

Radecka¹,

Litwiniuk²

2016

Ginekol Pol

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Breast cancer (BC) in young women is rare, affecting only 4-6% of women under the age of 40. Regardless, BC remains the most common malignancy among younger patients. Recently, a significant increase in BC rates has been observed among pre-menopausal subjects. Breast cancer in young women requires special attention due to its specific morphologic and prognostic characteristics and unique aspects, including fertility preservation and psychosocial issues (e.g. its impact on family life and career). Young women are more likely to have tumors with higher incidence of negative clinicopathologic features (higher histological grade, more lymph node positivity, lower estrogen receptor (ER) positivity, higher rates of Her2/neu overexpression). Also, they tend to be diagnosed at more advanced stages of the disease. That, in turn, contributes to less favorable prognosis as compared to older women. Young women are generally treated similarly to older patients. Surgical management includes mastectomy or breast-conserving surgery, followed by radiation therapy (younger women have higher local recurrence rates than older women, especially after breast-conserving therapy). Although the basics of chemotherapy are the same for patients of all ages, younger women have some special considerations. It is important to consider options for fertility preservation before starting systemic treatment. Patients should have access to genetic testing as their results may affect the choice of therapy. Younger women and their families should receive adequate psychological support and counselling.

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Section: Tumor Biologymentioning

confidence: 92%

Breast cancer in young women

Radecka¹,

Litwiniuk²

2016

Ginekol Pol

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“…Moreover, 59% of the tumors were high grade, 34% ER-negative (ER−), and 24% HER2-positive (HER2+). Patients with ER− tumors were associated with a worse 5-year overall survival (OS) compared with ER-positive (ER+) tumors 27 .…”

Section: Histopathologic Features Of Tumors In Young Womenmentioning

confidence: 99%

Molecular Biology In Young Women With Breast Cancer: From Tumor Gene Expression To Dna Mutations

Gómez-Flores-Ramos¹,

Castro-Sánchez

Peña-Curiel

et al. 2017

RIC

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Young women with breast cancer (YWBC) represent roughly 15% of breast cancer (BC) cases in Latin America and other developing regions. Breast tumors occurring at an early age are more aggressive and have an overall worse prognosis compared to breast tumors in postmenopausal women. The expression of relevant proliferation biomarkers such as endocrine receptors and human epidermal growth factor receptor 2 appears to be unique in YWBC. Moreover, histopathological, molecular, genetic, and genomic studies have shown that YWBC exhibit a higher frequency of aggressive subtypes, differential tumor gene expression, increased genetic susceptibility, and specific genomic signatures, compared to older women with BC. This article reviews the current knowledge on tumor biology and genomic signatures in YWBC.

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“…More recently, published data of the POSH study, the largest prospective observational study evaluating pathological characteristics of breast cancer patients under age 40, have shown that the majority of these patients had high-grade tumors (59%) of ductal histology (87%) 25 . Half of the patients had node-positive disease and multifocality was observed in 27% of patients.…”

Section: Clinicopathological Characteristics Of Breast Cancer In Younmentioning

confidence: 99%

“…Additionally, young patients with luminal types of breast cancer have a high risk for late distant relapse, since 40-50% of recurrences occur beyond the initial five years 25 . Therefore, second-generation gene expression profiles (PAM50, EndoPredict ® and BC Index) might serve as tools to predict the residual risk of distant relapse and to identify those young patients that would benefit from extended endocrine treatment.…”

Section: Clinicopathological Characteristics Of Breast Cancer In Younmentioning

confidence: 99%

General Overview and Treatment Recommendations for Young Women with Breast Cancer

Ribnikar

Ratoša

Perhavec

et al. 2017

RIC

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Prospective Observational Study of Breast Cancer Treatment Outcomes for UK Women Aged 18–40 Years at Diagnosis: The POSH Study

Abstract: These results confirm the increased frequency of ER-negative tumors and early relapse in young patients and also demonstrate the equally poor longer-term outlook of young patients who have ER-positive tumors with HER2-negative or -positive disease.

Cited by 167 publications

References 36 publications

Breast cancer in young women

Breast cancer in young women

Molecular Biology In Young Women With Breast Cancer: From Tumor Gene Expression To Dna Mutations

General Overview and Treatment Recommendations for Young Women with Breast Cancer

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