scholarly journals Postpartum breast cancer: mechanisms underlying its worse prognosis, treatment implications, and fertility preservation

2021 ◽  
Vol 31 (3) ◽  
pp. 412-422
Author(s):  
Hanne Lefrère ◽  
Liesbeth Lenaerts ◽  
Virginia F Borges ◽  
Pepper Schedin ◽  
Patrick Neven ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fertility Preservation ◽  
Young Women ◽  
Treatment Strategies ◽  
Premenopausal Women ◽  
Breast Cancers ◽  
Breast Cancer Outcome ◽  
Increased Risk ◽  
Cancer Outcome ◽  
Postpartum Breast Cancer

Breast cancers that occur in young women up to 5 to 10 years' postpartum are associated with an increased risk for metastasis and death compared with breast cancers diagnosed in young, premenopausal women during or outside pregnancy. Given the trend to delay childbearing, this frequency is expected to increase. The (immuno)biology of postpartum breast cancer is poorly understood and, hence, it is unknown why postpartum breast cancer has an enhanced risk for metastasis or how it should be effectively targeted for improved survival. The poorer prognosis of women diagnosed within 10 years of a completed pregnancy is most often contributed to the effects of mammary gland involution. We will discuss the most recent data and mechanistic insights of the most important processes associated with involution and their role in the adverse effects of a postpartum diagnosis. We will also look into the effect of lactation on breast cancer outcome after diagnosis. In addition, we will discuss the available treatment strategies that are currently being used to treat postpartum breast cancer, keeping in mind the importance of fertility preservation in this group of young women. These additional insights might offer potential therapeutic options for the improved treatment of women with this specific condition.

2042 Does pregnancy influence breast cancer outcome in young women?

1997 ◽  
Vol 39 (2) ◽  
pp. 261
Author(s):  
Anne de la Rochefordière ◽  
Bernard Asselain ◽  
Pierre Pouillart ◽  
François Campana ◽  
Krishna Clough ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

Does prior pregnancy influence breast cancer outcome in young women?

1998 ◽  
Vol 34 ◽  
pp. S98
Author(s):  
A. de la Rochefordière ◽  
B. Asselain ◽  
K. Clough ◽  
P. Pouillart ◽  
A. Fourquet
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

Fertility preservation options and the young breast cancer patient: A survey.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 575-575
Author(s):  
Manuela Jacobsen Junqueira ◽  
Shari Beth Goldfarb ◽  
Bridget A. Oppong ◽  
Sujata Patil ◽  
Anne Eaton ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Pilot Study ◽  
Fertility Preservation ◽  
Young Women ◽  
Ovarian Tissue ◽  
Ovarian Tissue Cryopreservation ◽  
Breast Cancers ◽  
Graduate Degree ◽  
Newly Diagnosed ◽  
Young Breast Cancer

575 Background: Approximately 15% of breast cancers (BC) are diagnosed in reproductive aged women. Management of the disease in this age group frequently includes chemotherapy and hormonal therapy, which can both affect fertility. Considering that age at first delivery has been steadily increasing, young women may face BC before completion of childbearing. Methods: In this prospective study, women referred to our institution for surgical treatment of BC were asked, before their first visit, to fill out a questionnaire regarding their reproductive history and fertility preservation knowledge. Eligible patients included women between the ages of 18 and 45, with a newly diagnosed BC, who had not yet started treatment. Results: Sixty women were eligible with a median age of 40 (range 20-45). 98% of responders (59 out of 60) had been diagnosed within the previous 2 months. 78% (47/60) had a college or post-graduate degree. 80% (48/60) had been pregnant before, while 86.5% (45/52) reported having had children. 81% (47/58) were premenopausal, and only 3 patients reported not having had periods for more than 1 year. 50% of responders (30/60) declared no interest in future childbearing, 25% were definitely interested, and 25% were undecided. However, only 9% (5/57) reported having received information on fertility preservation options before the survey. Women who have been pregnant were significantly less likely to consider fertility preservation options prior to treatment (egg/embryo/ovarian tissue cryopreservation [6% vs. 50%, p=0.001]), or after treatment (egg/embryo donation, surrogacy or adoption [6% vs. 58%, p<0.0001]). Conclusions: This pilot study was designed to gather information on reproductive health of newly diagnosed young BC patients and to assess their willingness to consider various fertility preservation options before or after treatment. Our study population consisted of mostly women who had been pregnant and had children. We found that 50% of the women were unsure or wanted future children. Yet, only 9% had received information on fertility options at diagnosis. This pilot study highlights the need for education and/or intervention in fertility preservation options for young women with breast cancer.

scholarly journals Identification of candidate mediators of chemoresponse in breast cancer through therapy-driven selection of somatic variants

2020 ◽  
Vol 183 (3) ◽  
pp. 607-616
Author(s):  
Waleed S. Al Amri ◽  
Diana E. Baxter ◽  
Andrew M. Hanby ◽  
Lucy F. Stead ◽  
Eldo T. Verghese ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Candidate Genes ◽  
Genomic Analysis ◽  
Predictive Markers ◽  
Chemotherapy Response ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Breast Cancer Outcome ◽  
Before And After ◽  
Cancer Outcome

Abstract Purpose More than a third of primary breast cancer patients are treated with cytotoxic chemotherapy, typically without guidance from predictive markers. Increased use of neoadjuvant chemotherapy provides opportunities for identification of molecules associated with treatment response, by comparing matched tumour samples before and after therapy. Our hypothesis was that somatic variants of increased prevalence after therapy promote resistance, while variants with reduced prevalence cause sensitivity. Methods We performed systematic analyses of matched pairs of cancer exomes from primary oestrogen receptor-positive/HER2-negative breast cancers (n = 6) treated with neoadjuvant epirubicin/cyclophosphamide. We identified candidate genes as mediators of chemotherapy response by consistent subclonal changes in somatic variant prevalence through therapy, predicted variant impact on gene function, and enrichment of specific functional pathways. Influence of candidate genes on breast cancer outcome was tested using publicly available breast cancer expression data (n = 1903). Results We identified 14 genes as the strongest candidate mediators of chemoresponse: TCHH, MUC17, ARAP2, FLG2, ABL1, CENPF, COL6A3, DMBT1, ITGA7, PLXNA1, S100PBP, SYNE1, ZFHX4, and CACNA1C. Genes contained somatic variants showing prevalence changes in up to 4 patients, with up to 3 being predicted as damaging. Genes coding for extra-cellular matrix components or related signalling pathways were significantly over-represented among variants showing prevalence changes. Expression of 5 genes (TCHH, ABL1, CENPF, S100PBP, and ZFHX4) was significantly associated with patient survival. Conclusions Genomic analysis of paired pre- and post-therapy samples resulting from neoadjuvant therapy provides a powerful method for identification of mediators of response. Genes we identified should be assessed as predictive markers or targets in chemo-sensitization.

scholarly journals Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2506
Author(s):  
Mark van Barele ◽  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Yvonne V. Louwers ◽  
Mijntje B. Vastbinder ◽  
John W. M. Martens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Hormone Replacement ◽  
Breast Cancers ◽  
Younger Women ◽  
Alternative Pathways ◽  
Increased Risk ◽  
History Of ◽  
Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

scholarly journals Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19566 ◽  
Author(s):  
Hikmat N. Abdel-Razeq ◽  
Razan A. Mansour ◽  
Khawla S. Ammar ◽  
Rashid H. Abdel-Razeq ◽  
Hadil Y. Zureigat ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Retrospective Study ◽  
Fertility Preservation ◽  
Young Women ◽  
Early Stage ◽  
Early Stage Breast Cancer

scholarly journals Determinants of genetic counseling uptake and its impact on breast cancer outcome: a population-based study

2014 ◽  
Vol 144 (2) ◽  
pp. 379-389 ◽  
Author(s):  
Aurélie Ayme ◽  
Valeria Viassolo ◽  
Elisabetta Rapiti ◽  
Gérald Fioretta ◽  
Hyma Schubert ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Genetic Counseling ◽  
Population Based ◽  
Population Based Study ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

scholarly journals Identification of a robust gene signature that predicts breast cancer outcome in independent data sets

BMC Cancer ◽  
2007 ◽  
Vol 7 (1) ◽  
Author(s):  
James E Korkola ◽  
Ekaterina Blaveri ◽  
Sandy DeVries ◽  
Dan H Moore ◽  
E Shelley Hwang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Gene Signature ◽  
Data Sets ◽  
Independent Data ◽  
Breast Cancer Outcome ◽  
Cancer Outcome

scholarly journals The risk of breast, cervical, endometrial and ovarian cancer in oral contraceptive users

2010 ◽  
Vol 63 (9-10) ◽  
pp. 657-661 ◽  
Author(s):  
Milena Veljkovic ◽  
Slavimir Veljkovic
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cervical Cancer ◽  
Oral Contraceptive ◽  
Oral Contraceptives ◽  
Young Women ◽  
Contraceptive Use ◽  
Epidemiologic Studies ◽  
Oral Contraceptive Use ◽  
Increased Risk

Introduction. Oral contraceptives, mainly combined monophasic pills, are widely used by young women who expect their physicians to prescribe them safe drugs which will not harm their health and which will simplify their life. Numerous epidemiologic studies have been performed to determine the relation between oral contraceptive use and the development of neoplasms. Breast cancer. An increased incidence of breast cancer has occurred simultaneously with the growing use of oral contraceptives. The possibility of a link between the oral contraceptive use and breast cancer has led to intensive research, but studies have provided inconsistent results causing confusion among clinicians. It was noticed that the risk of breast cancer was slightly elevated in current and recent young oral contraceptives users. That finding could be influenced by a detection bias or could be due to the biologic effect of the pills. The absolute number of additional breast cancer cases will be very small because of low baseline incidence of the disease in young women. Oral contraceptives probably promote growth of the already existing cancer, they are probably promoters not initiators of breast cancer. The available data do not provide a conclusive answer that is need. Cervical cancer. Numerous factors may influence the development of cervical cancer. The evidence suggests that current and recent oral contraceptive users have an increased risk of cervical cancer which decline after discontinuation of the application of medication. Oral contraceptives might increase the biological vulnerability of the cervix. Cervical cancer develops slowly over a long time period and can be effectively prevented by periodic cervical screening. Fortunately, oral contraceptives do not mask abnormal cervical citology. Conclusions regarding invasive cervical cancer and oral contraceptive use are not definitive but if there is any increased risk, it is low. Endometrial cancer. In oral contraceptive users the endometrium is almost under the influence of progestin component which suppresses endometrial mitotic activity and its proliferation. Most epidemiologic studies show that oral contraceptives reduce the risk of endometrial cancer and that this protective effect exists many years after the discontinuation of medication. Ovarian cancer. It has been long known that the oral contraceptive use causes protective an ovulation and reduces the risk of ovarian cancer. This powerful reduction is the best demonstrated major benefit of oral contraception. This protection is especially observed in nulliparous and seems to persist for many years after the discontinuation of medication.

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