Significant Proportion Of Young Women Research Articles

Elective Oocyte Cryopreservation: What Patients Understand and What They Need to Understand

Life circumstances, including not having a partner, may prevent women from having children during their most fertile years. To avoid age-related infertility women who plan to have children at an age when their fertility is likely to have declined can freeze their eggs when they are younger and use them in an assisted reproductive technology (ART) procedure when the time for childbearing is right for them. Research shows that a significant proportion of young women would consider safeguarding their reproductive potential or are at least open to the idea of oocyte freezing. To make informed decisions about fertility preservation women need accurate and realistic information about the likelihood of a live birth considering their circumstances; the cost of retrieval, storage, and later use of the eggs; the known and potential risks of the procedure for the woman herself and any future children; and the potential emotional risks of elective oocyte cryopreservation. In this presentation I will suggest how clinics can ensure women have all the information they need to make the best possible decision they can about if and when to freeze their eggs.

Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer.

Background:Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available.Methods:We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41–69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns.Results:Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20–40). Compared with women aged 41–69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR–/HER2– disease known as “triple negative breast cancer” (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2– patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0–51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2–, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015).Conclusion:De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

FEATURES OF PREGNANCY AND DELIVERY IN ADOLESCENT WOMEN

Aim: to assess the risk of adverse consequences of adolescent pregnancy for mother and foetus in women from Lviv region. Material and methods. Complications of pregnancy and childbirth in adolescent women were studied retrospectively at the Lviv Regional Clinical Hospital. Results and discussion. 134 cases of adolescent childbirths for 2013 to 2017 were analyzed. The analysis of data on the course of pregnancy in adolescent women showed that the vast majority of them had complicated pregnancy and were at risk of preterm childbirth. A significant proportion of young women, 78 (58.2%), significantly more often required the therapy during pregnancy. Assessment of the health status of newborns showed that ¼ (24.6%) of young women gave birth to premature babies, and almost 1/3 of children, 51 (38.0%), from young mothers had a complicated early neonatal period. Within the spectrum of complications, the commonest diagnosis was "prematurity" in 33 (24.6%) children from young mothers. The pathological course of the early neonatal period in 51 (38.0%) children of the main group required transfer to other departments for further treatment. 82 (61.2%) children from this group were discharged home, while in the control group all 100 (100.0%) children were discharged from maternity home. Conclusions. The study has demonstrated that the risk factors for perinatal pathology in newborns from adolescent women included probably complicated pregnancy, risk of spontaneous abortion (17.9%), preterm birth (24.6%), and the childbirth of premature infants with impaired condition at birth, who needed treatment in other medical institutions (38.0%). Adolescent pregnant women are at risk for obstetric and perinatal complications.

Abstract A49: BRCA1 deficiency is a recurrent event in early onset triple-negative breast cancer (TNBC): A comprehensive analysis of germline mutations and somatic promoter methylation

Abstract Background: Triple-negative breast cancer (TNBC) is a breast cancer subtype that accounts for 15-20% of all breast cancer cases. TNBC treatment is challenging because it does not respond to conventional hormonal and available target therapies, which are effective in other subtypes, making systemic chemotherapy the mainstay treatment. Moreover, TNBC displays higher aggressiveness and distinct metastatic pattern compared to other breast tumors, resulting in worse prognosis and survival. We and others have identified high prevalence of BRCA1 germline mutation in TNBC. However, BRCA1 deficiency may also be caused by somatic gene promoter methylation among other mechanisms. BRCA1/2 deficiency may lead to impairment of DNA repair and tumor development. Hence, understanding the mechanisms of BRCA deficiency in driving this tumor subtype, in both hereditary and sporadic scenery, is of great clinical and biologic interest. Methods: We included in this study TNBC samples unselected for age or family history and attending A. C. Camargo Cancer Center. Tumor tissues were screened for point mutation in BRCA1/2 using next-generation sequencing (NGS). Sanger sequencing was performed in both tumor and normal tissue/leucocyte for categorizing the pathogenic mutations in germline or somatic. Multiplex Ligation-dependent Probe Amplification (MLPA) was used to investigate BRCA1 copy number alterations (CNA) resulting from large rearrangements in tumor and leucocyte. Additionally, for BRCA1 gene silencing investigation a customized bisulfite NGS approach was performed to assess the BRCA1 promoter methylation in tumor tissue. Results: Point mutations were screened in 131 TNBC tumor samples, detecting a total of 18 pathogenic mutations (13.7%)---16 (88.8%) in BRCA1 and 2 (11.2%) in BRCA2. No large rearrangement was detected by MLPA in tumor tissue or leucocyte. Mutations classified as germline accounted for the majority of the pathogenic mutations detected in tumor tissue (93.75% - 15/16)---81.25% (13/16) in BRCA1 and 12.5% (2/16) in BRCA2. Only one somatic mutation was detected (6.25% - 1/16) in BRCA1 gene. Considering early onset TNBC (≤40 year of age) the germline mutation rate increased to 25% (8/32), mainly in BRCA1 gene (22% - 7/32). BRCA1 promoter hypermethylation in tumor was detected in 20.6%, all in sporadic TNBC, with a slight increase to 28% in early onset cases. Ultimately, BRCA impairment by either constitutive or somatic events was identified in 34% (45/131) of the cases and was significantly more frequent in young women (56% in ≤40; 33% in 41-50; 23% in &amp;gt;50 year of age; p=0.007) and associated with better overall and disease-free survival rates in this group of patients. Conclusions: We observed that a high number of the TNBC cases are hereditary and BRCA1-related, especially in young women. For the sporadic cases, BRCA1 gene silencing was also a recurrent event. Taken together, our data showed that BRCA1 impairment (either by germline mutation or somatic promoter hypermethylation) was present at high frequency in the early-onset cases and was associated with better survival for these patients. With the new treatment modalities including Poly (ADP-ribose) polymerase (PARP) inhibitors being investigated, our results shed light that a significant proportion of young women with TNBC might benefit from PARP-inhibitor and future investigation in this subject is warranted. Citation Format: Rafael Canfield Brianese, Kivvi D. M. Nakamura, Fernanda G. S. R. Almeida, Rodrigo F. Ramalho, Elisa N. Ferreira, Bruna D. F. Barros, Maria N. C. Formiga, Victor P. Andrade, Vladmir C. C. Lima, Dirce M. Carraro. BRCA1 deficiency is a recurrent event in early onset triple-negative breast cancer (TNBC): A comprehensive analysis of germline mutations and somatic promoter methylation [abstract]. In: Proceedings of the AACR International Conference held in cooperation with the Latin American Cooperative Oncology Group (LACOG) on Translational Cancer Medicine; May 4-6, 2017; São Paulo, Brazil. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(1_Suppl):Abstract nr A49.

BRCA1 deficiency is a recurrent event in early-onset triple-negative breast cancer: a comprehensive analysis of germline mutations and somatic promoter methylation.

BRCA1 germline mutation is closely associated with triple-negative breast cancer. BRCA deficiency leads to impaired DNA repair and tumor development, and understanding this deficiency, in both hereditary and sporadic scenarios, is of great clinical and biological interest. Here, we investigated germline or somatic events that might lead to BRCA1 impairment in triple-negative breast cancer. We also analyzed the clinical implications associated with BRCA deficiency. Next-generation sequencing for the BRCA1/2 genes and multiplex ligation-dependent probe amplification (MLPA) for the BRCA1 gene were performed for mutation screening. A customized bisulfite next-generation sequencing approach was used for assessing BRCA1 promoter methylation status in tumor tissue. A total of 131 triple-negative cases were assessed, and germline pathogenic variants were detected in 13.0% of all cases and in 26% of cases diagnosed in young women. Most germline pathogenic variants (88.2%) occurred in the BRCA1 gene. BRCA1 promoter hypermethylation was detected in 20.6% of tumors; none of these tumors were in BRCA1/2 pathogenic variant carriers. BRCA1 impairment by either germline or somatic events was significantly more frequent in young women (55% in those≤40years; 33% in those 41-50years; 22% in those>50years of age) and associated with better overall and disease-free survival rates in this group of patients. BRCA1 deficiency was recurrent in early-onset triple-negative breast cancer in Brazilian patients and associated with improved survival. With the new treatment modalities being investigated, including poly (ADP-ribose)-polymerase (PARP) inhibitor therapy, our results suggest that a significant proportion of young women with this subtype of tumor might benefit from PARP inhibitor treatment, which warrants further investigation.

Prospective observational study in early breast cancer at University Hospital of Tlemcen

Background: Breast cancer is the first cancer in women in Algeria. It affects a significant proportion of young women. Stage at diagnosis is made with a positive, massive, and often lymph node involvement. The objective of this study is to determine the clinicopathological and histological features of patients treated for invasive breast carcinoma.&#x0D; Methods: This is an observational prospective study from January 2006 to December 2011 done at the medical oncology department at the University Hospital Center of Tlemcen: 103 patients with early breast cancer were included.&#x0D; Results: Extreme age is between 29 and 70 years; 50% of patients are under 47 years. The average age at diagnosis of 46.45 ± 0.90 years; 54% are stage T2; 17% are stage T3 and 4% stage T4; stage III is the most frequent with 50.4%. Half of patients have four to nine nodes with relatively wide tumor size, and only one patient was stage I; 10% had more than 10 positive nodes. The infiltrating ductal carcinoma is the most common histological types (83.5%), followed by atypical carcinoma (5.82%). Note the predominance of grade II of Scarf Bloom and Richardson (58.25%), followed by grade III (36.89%) and grade I (1.91%). Over 50% of patients had a tumor size of 35.41 ± 1.82 mm. Hormone receptors were positive in 65% of patients (ER + PR +) and negative in 35%. HER2 status was determined in 82 patients, 12% expressed a positive score, and 67% of were negative. The luminal profile is the most common in our study population with 57.3%, followed by triple negative tumors or basal-like with 26.8%. Conservative surgical treatment was realized in 2.9% and an astectomy in most patients at 97%. Radiotherapy was performed in 83.5% of patients, and 65% of patients received hormone therapy according to hormone positivity.&#x0D; Conclusion: The clinical and histological profiles of the patients in our study population are different from Western populations by the average age of diagnosis of 46 years, 10 years higher for Western women, and the stage is more advanced for our population. The majority are at stage III, while Western women are diagnosed at stage I or II through screening. Given the Algerian profile, women should be offered screening at aged 40 years for earlier diagnosis and improved survival rate.

Teen Daughters and Their Mothers in Conversation: Identifying Opportunities for Enhancing Awareness of Risky Tanning Behaviors

PurposeThe incidence of melanoma has been increasing dramatically among teenage and young adult women over the past several decades. Despite a causal link between ultraviolet light exposure and melanoma, a significant proportion of young women intentionally tan. Furthermore, we know very little about the family's role in melanoma-related risk practices. MethodsThis study examined 22 interviews of adolescent girls and their mothers discussing topics related to sun protection and tanning behavior. ResultsQualitative analysis elicited four primary themes: (1) high rates of prior discussion about indoor tanning; (2) discussion of other risky behaviors that are considered more important than tanning; (3) a desire for increased knowledge of risky tanning behavior; and (4) change in tanning behavior with relevant life experience. ConclusionsResults emphasize the value of educational interventions designed to raise melanoma-related risk awareness and suggest the potential benefit of improving knowledge maintenance and family engagement through information sharing.

A survey on the intentions and attitudes towards oocyte cryopreservation for non-medical reasons among women of reproductive age

Although cryopreservation of semen is a routine procedure for preserving male gametes, an efficient method of preserving fertility through oocyte freezing has only recently become available for women. In view of the limited female reproductive lifespan, oocyte freezing can now offer women some protection against the decline in fertility with aging. A survey was performed in Belgium among 1914 women of reproductive age (21-40 years) to assess public attitudes towards the phenomenon called 'social oocyte freezing'. Women were questioned on their awareness of the age-related fertility decline and their views and intentions towards considering undergoing oocyte cryopreservation. The electronic questionnaire was completed by 1049 women, giving a response rate of 55%, and 25 were excluded as they were incomplete/inconsistent. Our results demonstrate that 31.5% of respondents consider themselves as potential social oocyte freezers, of which 3.1% would definitely consider the procedure. Just over half of the women (51.8%) would not consider the procedure while 16.7% indicated they had no opinion. Potential oocyte freezers are characterized by a higher number of desired children and more openness to oocyte donation. The decision to actually embark on such treatment would primarily depend on conditions, such as the procedure not affecting their natural fertility and the health of future children. We conclude that a significant proportion of young women would consider safeguarding their reproductive potential or are at least open to the idea of social oocyte freezing.

Fertility treatments and the young women who use them: an Australian cohort study

In Australia, fertility treatment is partly or wholly reimbursable under federal benefits schemes, without restrictions on age, number of treatment cycles or existing family size. In this study, we aimed to characterize the potential need for and use of fertility treatments in a population-based cohort of young Australian women. We conducted structured interviews with 974 members of a cohort constructed by tracing all female infants born at a single general hospital in Adelaide between 1973 and 1975. The main outcome measures were pregnancy history, difficulty becoming pregnant and assistance sought to become pregnant. Of 657 women aged 30-32 who had sought pregnancy, 24% reported difficulty becoming pregnant and 26% had lost at least one pregnancy. Ovulatory problems (16%) and male fertility problems (13%) were common among those with difficulty. Over half of the women who had difficulty conceiving (58%) sought assistance, largely from specialists (53%). Consultations, tests and education only were common (22%), as were IVF/ICSI (17%). Close to a third (28%) of those seeking assistance were treated only with clomiphene, as were two-thirds (67%) of women with ovulatory problems. In this study, almost a quarter of women in their early 30s reported difficulty conceiving, and over a quarter reported pregnancy loss. This suggests that a significant proportion of young women experience substantial difficulties becoming pregnant. Our findings highlight the need to continue to document the range of women's reproductive experiences and to monitor fertility and treatment-seeking trends.

Relationships among Sociodemographic Markers, Behavioral Risk, and Sexually Transmitted Infections in U. S. Female Marine Corps Recruits

The purpose of this study was to examine the effect of sociodemographic factors and constructs derived from the Information, Motivation, and Behavioral Skills (IMB) model on sexually transmitted infections (STIs) and a composite STI risk score in female Marine Corps recruits. Data were collected in 1999 to 2000 through self-administered questionnaires and laboratory-confirmed tests of STIs. Logistic regression analyses were used to assess factors associated with sexual risk and STIs. Recruits with the highest STI risk scores were younger, single, had high STI knowledge, less positive condom attitudes, perceptions of higher STI risk, perceived that sex is more likely and enjoyable under the influence of alcohol, and were heavy alcohol and drug users before recruit training entry. Recruits diagnosed with STIs had higher STI risk scores, had last sexual partners who were non-Caucasian, and resided in rural locations before recruit training entry. A significant proportion of young women entering the Marine Corps present with STIs and/or recent sexual behavior that put them at risk for acquiring STIs despite high group means for prevention skills. Deficiencies in STI/human immunodeficiency virus knowledge and motivation to reduce risk (denoted by negative attitudes toward condom use and acceptance of the connection between sex and substance use) are possible targets for intervention.

The impact of urinary stress incontinence in young and middle-age women practising recreational sports activity: an epidemiological study

Objectives:To evaluate the prevalence of urinary stress incontinence (USI) in menstruating women practising recreational sports activity, to detect specific sports with a stronger association with urinary incontinence (UI) and to...

Award-winning Abstracts from the SOGC Annual Clinical Meeting 2001

Background: Adolescent pregnancies in Canada have increased to 42.7/1000/year in 1997 with birth rates of 20/1000/year. The delay between the initiation of sexual activity and the initiation of consistent use of contraception has been seen as one of the most important obstacles to the prevention of adolescent pregnancy. Efforts to decrease teen pregnancy rates through increasing education and access to contraception assume that adolescent pregnancies are unplanned, unintended, and unwanted.Objective: The aim of this pilot study was to retrospectively determine what percentage of Canadian adolescents presenting for antenatal care truly desired pregnancy. Our hypothesis was that a significant proportion of young women intended or attempted to conceive and thus would not benefit from current approaches to teen pregnancy prevention.Study Methods: All teens presenting to a multidisciplinary adolescent obstetric clinic between March 1999 and December 2000 were asked to complete an anonymous mini questionnaire about pregnancy wantedness at their initial visit. Seventy-eight new patients were seen over that time frame and 58 responded to two questions concerning: 1) their desire for pregnancy prior to conceiving and 2) their feelings about the pregnancy now.Results: In response to question #1, 22/58 adolescents had “sort of” or “really” wanted to be pregnant and 32/58 “had not wanted” to be pregnant and 4/58 “had not cared” if they were pregnant. In response to question #2, 42/58 were happy that they were pregnant and 16/58 were not sure how they felt about being pregnant.Conclusions: Efforts to promote awareness and availability of contraception would not likely have prevented 1/3 of the adolescent pregnancies in this small Canadian cohort of soon-to-be teen mothers. This sample is not representative of the entire pregnant teenage population; approximately half of adolescent pregnancies are terminated and this may explain why there were no teenagers in our cohort who at their first antenatal visit were unhappy about being pregnant. Public Health initiatives directed at reduction of teen pregnancies must also take into account the adolescent attitudes toward pregnancy.

Desire for pregnancy among adolescents in an antenatal clinic

BACKGROUND: Adolescent pregnancies in Canada have increased to 42.7/1000/ yr in 1997 with birth rates of 20/1000/yr. The delay between the initiation of sexual activity and the initiation of consistent use of contraception has been seen as one of the most important obstacles to the prevention of adolescent pregnancy. Efforts to decrease teen pregnancy rates through increasing education and access to contraception assume that adolescent pregnancies are unplanned, unintended, and unwanted.OBJECTIVE: The aim of this plot study was to retrospectively determine what percentage of Canadian adolescents presenting for antenatal care truly desired pregnancy. Our hypothesis was that a significant proportion of young women intended or attempted to conceive and thus would not benefit from current approaches to teen pregnancy prevention.METHODS: All teens presenting to a multidisciplinary adolescent obstetric clinic between March 1999/ December 2000 were asked to complete an anonymous mini questionnaire about pregnancy wantedness at their initial visit. Seventy-eight new patients were seen over that time frame and 58 responded to two questions concerning: 1) Their desire for pregnancy prior to conceiving and 2) their feelings about the pregnancy now.RESULTS: In response to question #1, 22/58 adolescents had “sort of” or “really” wanted to be pregnant and 32/58 “had not wanted” to be pregnant and 4/58 “had not cared” if they were pregnant. In response to question #2, 42/58 were happy that they were pregnant and 16/58 were not sure how they felt about being pregnant.CONCLUSIONS: Efforts to promote awareness and avail-ability of contraception would not likely have prevented 1/3 of the adolescent pregnancies in this small Canadian cohort of soon-to-be teen mothers. This sample is not representative of the entire pregnant teenage population; approximately half of adolescent pregnancies are terminated and this may explain why there were no teenagers in our cohort who did not want to be pregnant. Public health initiatives directed at reduction of teen pregnancies must also take into account adolescent attitudes toward pregnancy.

Sex, alcohol and drugs? Young people's experience of Schoolies Week.

The 'Schoolies Week' phenomenon attracts more than 10,000 school leavers to Surfers Paradise in November and December each year. In a survey of these young people (N = 1796), from Queensland, New South Wales (NSW), and Victoria, about two-thirds of the young men and one-third of the young women expected to have sexual intercourse while in Surfers Paradise. Of these, about 80 per cent expected to use condoms. Most expected to be drunk most nights or every night of their holidays and 27 per cent of young men and 17 per cent of young women expected to be 'stoned' most nights or every night. Most young men and a significant proportion of young women achieved these expectations, with respondents from NSW and Victoria being more likely to do so than Queensland residents. Over one-third of the sample had engaged in sexual intercourse prior to interview, and of these, two-thirds of young men and over half the young women always used condoms with casual partners. The rates for sexual intercourse with regular partners were slightly lower. Those who were inconsistent condom users on holiday were likely to have a history of inconsistent condom use and to have multiple casual partners and/or regular partners in addition to casual partners. It is recommended that the NSW and Victorian governments accept some responsibility for the behaviour of young people attending Schoolies Week. A coordinated intervention strategy is required because there are significant prior indicators of young people's risk practices in Surfers Paradise during Schoolies Week.