Breast Cancer in Young and Premenopausal Women

Abstract

Abstract Breast cancer is not a unique disease. In the last 10 years it has become quite clear that breast cancer can be separated into different categories with treatment implications. Patients younger than 40 years of age can be considered as a special population. The bilogicla features are different these women have of special needs. In early breast cancer their tumours are more often hormone-receptor negative, of higher grade and in general more aggressive. Young women with breast cancer tend to have an inferior disease free and overall survival. The use neoadjuvant of chemotherapy results in higher pathological complete response rates than in elderly women. The younger the patients the higher the pCR rate. In data form the TAILOR-X study premenopausal women with an intermediate recurrence score benefit from chemotherapy. One theory might be that these women render menopausal by using chemotherapy . This hypothesis needs to be further examined. Data from the ZORO study in the late 90s confirmed that the DFS in premenopausal women is similar between 2years of LHRH analogues and 6 cycles of CMF. Both treatments are considered not standard of care anymore but underline that a substantial effect of chemotherapy is rendering the women postmenopausal. Young women need to be acknowledged a separate entity.