Diagnostic and treatment delays in young women with breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6575-6575
Author(s):  
Philip D Poorvu ◽  
Yue Zheng ◽  
Tal Sella ◽  
Shoshana M. Rosenberg ◽  
Kathryn Jean Ruddy ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Underserved Populations ◽  
Post Partum ◽  
Signs And Symptoms ◽  
Baseline Survey ◽  
Factors Associated ◽  
Breast Cancer Study ◽  
Additional Support ◽  
Stage 1

6575 Background: Delays in diagnosis (dx) and treatment (tx) affect breast cancer (BC) outcomes. We sought to identify factors associated with delays among young women, who do not undergo routine screening and often have pregnancy or breastfeeding-related breast changes that may mask a BC. Methods: The Young Women’s Breast Cancer Study is a multicenter, prospective cohort that enrolled 1302 women with newly dx BC age ≤40 between 2006-2016. Women reported the method and timing of cancer detection on the baseline survey. 231 were ineligible or excluded due to missing information. Among those reporting self-detected cancers, using multivariable regression we evaluated factors associated with delays ≥90 days (d) from symptom to presentation (self delay) and presentation to dx (care delay); in stage 0-III BC we evaluated delays ≥60d from dx to tx (tx delay). Results: 1071 eligible women had median age at dx of 37 yrs (17-40) and 74% reported self-detected cancers. Self delay or care delay ≥90d was reported in 17% and 13%, respectively. Factors inversely associated with self delay included pregnancy at dx (vs nulliparous, OR 0.10, CI 0.01-0.78) and perceived financial comfort (vs not, OR 0.62, CI 0.41-0.93). Women dx ≤1 year post-partum who breastfed (vs nulliparous, OR 2.60, CI 1.14-5.93) and those with a family history of breast/ovarian cancer (vs none, OR 1.79, CI 1.00-3.19) were more likely to have a care delay. Age was inversely associated with care delays (OR 0.94, CI 0.89-0.99). Tx delay was reported by 10% (105/1015), and associated with being single (vs partnered, OR 1.61, CI 1.02-2.56 ), non-white (vs white, OR 1.85, CI 1.09-3.13) and having Stage 0 BC (vs stage 1, OR: 3.08, CI 1.65-5.77); women with stage 3 BC (vs stage 1, OR 0.13, CI 0.03-0.56) were less likely to have a tx delay. Conclusions: In this cohort, most young women with BC underwent timely dx and tx initiation. Women dx ≤1 year post-partum who breastfed were more likely to experience a care delay, likely because lactational changes may mask BC signs and symptoms. The associations of perceived financial status with self delay and non-white race with tx delay underscore the need for additional support to ensure timely care for underserved populations with the goal of eliminating disparities in outcomes.

Quality of life and psychosocial distress in young women with advanced breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20508-e20508
Author(s):  
Davinia Shien Seah ◽  
Shari Gelber ◽  
Kathryn Jean Ruddy ◽  
Rulla M. Tamimi ◽  
Lidia Schapira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
General Population ◽  
Young Women ◽  
Bodily Pain ◽  
Psychosocial Distress ◽  
Baseline Survey ◽  
Factors Associated ◽  
Sf 36

e20508 Background: Little is known about the quality of life (QOL), prevalence and predictors of psychosocial distress in young women with advanced breast cancer (ABC). Methods: As part of an ongoing longitudinal multi-center study of women aged < 40 with newly diagnosed breast cancer, we identified women with ABC. Using baseline survey and medical chart data, we assessed QOL (measured by the Medical Outcomes Study Short Form-36 [SF-36], with norm based means [NBM] <47 indicating a clinically meaningful worsening QOL compared to the general population), and evaluated relationships between demographic and clinical variables and psychosocial distress (measured by the Hospital Anxiety and Depression Scale [HADS], with higher scores indicating more distress). Demographic and clinical factors were tested in univariate models. Factors with a p < 0.2 were evaluated in multivariate models to determine factors associated with anxiety or depression (HADS subscale scores >11). Results: Of the 725 women who completed a baseline survey, 40 had ABC. Median age of ABC diagnosis was 37 (range 23-40). Median time between diagnosis and survey completion was 143 days. Other than general health (NBM 56.8) and role limitations due to emotional problems (NBM 53.8), SF-36 subscale scores of young women with ABC were lower compared to the general population, especially, bodily pain (NBM 27.4), social functioning (NBM 33.5) and mental health (NBM 44.3) scores. Physical and mental component summary NBM scores were 44.3 and 45.8 respectively. 30% (12/40) were anxious and 10% (4/40) were depressed according to HADS. The 4 depressed women also met criteria for anxiety. Women who were more financially comfortable were less anxious (OR 0.07, p=0.04). Logistic regression identified no other factors associated with anxiety, and no factors were associated with depression. Conclusion: QOL is impaired in young women with recently diagnosed ABC, particularly from bodily pain and disruption to social functioning. Many young ABC patients are anxious, while few are depressed. This study will be expanded to include young women who progressed to ABC. Further research is warranted to evaluate interventions to improve QOL and psychosocial distress in this population.

Characterizing attitudes related to child-bearing in young women diagnosed with early breast cancer (EBC).

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 165-165
Author(s):  
Saumya Umashankar ◽  
Moming Li ◽  
Mi-Ok Kim ◽  
Hope S. Rugo ◽  
Michelle E. Melisko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Care Center ◽  
Baseline Survey ◽  
Full Time ◽  
Incurable Cancer ◽  
Receptor Status ◽  
Child Bearing ◽  
Future Child ◽  
Increasing Risk

165 Background: Young women diagnosed with breast cancer face unique challenges. The desire to have a biologic child (bchild) is often a factor in treatment decisions at diagnosis and follow-up. The aim of this study is to characterize the intentions, attitudes, and decision factors considered by young women who desire to have a bchild after a diagnosis of EBC. Methods: This prospective study included young women diagnosed with stage 1-3 EBC under age 45 who saw an oncologist at UCSF’s Breast Care Center (BCC). Young women < 6 months from diagnosis were invited to complete a baseline REDCap survey on fertility, child-bearing, and family-building. Descriptive statistics were used to summarize responses. Chi square and independent samples t tests were used to compare demographics. Covariates were analyzed using odds ratios. Results: From Feb 2018 to Dec 2020, 166 eligible pts seen at the UCSF BCC were contacted, 143 pts consented, and 108 (75.5%) completed the baseline survey. Of the 108 pts, 57 (53%) were interested in having a bchild in the future. Age was the biggest driver of whether participants were interested in future child-bearing vs. not (Mean = 35.4 vs 40.9, p < 0.001) and was not influenced by stage, receptor status, or treatment. 73.6% (N = 42) of those interested in future child-bearing underwent or planned to undergo fertility preservation (FP). FP was associated with full time employment (p = 0.03) and higher education (p = 0.02). Of the 57 pts interested in future child-bearing (42 HR+, 11 TN, 12 HER2+), 30% wished to start trying to conceive within 2 years from diagnosis, and only 20% would wait 5 years or more. 43% (N = 18) of those with HR+ disease were willing to complete 5 years of hormone therapy (HT) before trying to conceive. Given hypothetical risk scenarios of an incurable cancer recurrence, 16.3% of participants were interested in a future bchild despite a 75-100% hypothetical risk of recurrence (ROR). Young women self-identified as Asian were less inclined to pursue child-bearing with increasing risk (OR = 0.3 vs. Caucasian, p = 0.04), while BRCA-carriers were more likely to remain interested in future child-bearing despite increasing risk (OR = 6.43 vs. non-carriers, p = 0.03). 59% would stop adjuvant HT early if the hypothetical absolute increased ROR from early discontinuation was < 10%. Conclusions: In this single-institution study, over half of young women with EBC expressed a desire to have a future bchild. This was independent of stage, receptor status, and treatment; the majority of women wished to conceive < 5 years from diagnosis. The desire for a future bchild decreased with increasing hypothetical risk of incurable recurrence; however, a subset wished to attempt child-bearing even when an incurable recurrence was certain. Having a bchild after EBC is a priority for many young women and should be addressed at diagnosis and throughout the continuum of care.

Abstract 3450: Epidemiological factors associated with breast cancer in young women

2016 ◽  
Author(s):  
Allyson L. Toro ◽  
Matthew T. Hueman ◽  
Craig D. Shriver ◽  
Rachel E. Ellsworth
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Factors Associated ◽  
Epidemiological Factors

scholarly journals Patient and provider factors associated with the noninitiation of tamoxifen for young women at high‐risk for the development of breast cancer

2020 ◽  
Vol 26 (3) ◽  
pp. 464-468
Author(s):  
Pridvi Kandagatla ◽  
Natalie N. Rizk ◽  
Danijela Dokic ◽  
Jeannie Kochkodan ◽  
Samantha Estevez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Young Women ◽  
Factors Associated

Pregnancy-associated breast cancer (PABC): Czech Young Breast Cancer Study Group Project 35.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 265-265
Author(s):  
M. Zimovjanova ◽  
P. Tesarova ◽  
B. Konopasek ◽  
J. Barkmanova ◽  
P. Brabec ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Complete Remission ◽  
Metastatic Disease ◽  
Young Women ◽  
Psychosocial Support ◽  
Post Partum ◽  
Healthy Children ◽  
Group Project ◽  
Clinical Registry ◽  
One Year

265 Background: Breast cancer (BC) is the most common cancer in women. 12% of BC occur in women age 20–34. BC is classified as “pregnancy associated” if it is diagnosed during pregnancy or within one year after the delivery (PABC). We propose two distinct subtypes of PABC: BC diagnosed during pregnancy and BC diagnosed post-partum. This distinction is important because epidemiologic data highlights worsened outcomes specific to post-partum cases. The safety of pregnancy after treatment of BC is an important issue for many young women. Current research does not indicate that pregnancy negatively affects survival. Methods: There are about 95 young women being diagnosed each year with BC in the Czech Republic. A project of clinical registry named “Project 35” was launched in 2005 with the aim to collect data on epidemiology of the disease in young women. The standardization of the multidisciplinary medical treatment, genetic counselling and psychosocial support should result in better clinical outcomes and improve the quality of life. Results: In our project (n=225) were referred 25 women with PABC, 9 patients with the diagnosis of breast cancer during the pregnancy, 16 patients within one year after the delivery. 2 patients underwent termination of the pregnancy (first trimester) before oncological treatment, in 2 patients anthracycline-based chemotherapy was administered (second trimester), and in 5 patients were induced preterm delivery (third trimester). After delivery we followed standard therapeutic guidelines. All patients are alive but three of them have metastatic disease. From 16 women treated for post-partum BC, 11 patients have complete remission, 2 are alive with metastatic disease, 1 is recovering after the surgery for local recurrence and 2 patients died due to progressive disease. 8 women are BRCA1/2 carriers. 8 women after the successful treatment of breast cancer have delivered of healthy children and are in a complete remission, despite 1 of them with local reccurence of breast cancer. Conclusions: PABC is rare situation, which needs to be managed individually. These patients should be treated under the supervision of the Oncological Centres. Project 35 is useful framework for the counselling in PABC.

Time to cancer diagnosis in young women presenting to surgeons with breast-related symptoms: A population-based cohort study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13099-e13099
Author(s):  
Tehillah S Menes ◽  
Tal Sella ◽  
Gabriel Chodick
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Young Women ◽  
Cancer Diagnosis ◽  
Breast Imaging ◽  
Breast Biopsy ◽  
Post Partum ◽  
Age Groups ◽  
Population Based ◽  
Diagnosis Of Cancer

e13099 Background: Reports on delay to diagnosis of cancer in young women are based on retrospective studies and conflicting. The purpose of this study was to investigate time to cancer diagnosis in women presenting to a surgeon with breast-related complaints; and particularly, the role of age. Methods: A population-based cohort study including all women aged 18 to 44 presenting to a surgeon with a breast-related complaint between 2005 and 2015 in a large Israeli healthcare plan (N = 157,264). We collected data including demographics, diagnosis codes, breast imaging and biopsies. Breast cancer diagnosis within one year of the visit was ascertained from the national cancer registry. Time to breast imaging and biopsy was compared between the different age groups. Logistic regression analysis was used to determine the association between age and delay to biopsy while adjusting for possible confounders. Results: During the first year after the visit, 45,434 (29%) women had a breast imaging study; 5,767 (3.7%) women had a breast biopsy; and 676 (0.43%) were diagnosed with breast cancer. Overall, time to first breast imaging (mean, 53 days) and biopsy (mean, 68 days) did not differ significantly between the age groups. Non-specific visit codes (other than breast mass) were associated with delays to imaging and biopsy. This was more pronounced in the women ultimately diagnosed with breast cancer. Among women diagnosed with breast cancer, age under 40 (OR 2.3, 95% CI 1.4; 3.9), being post-partum (OR 2.6, 95% CI 1.1; 5.9) and a non-specific visit code (OR-8.3, 95% CI 4.9; 14.2) were associated with delay to biopsy. Conclusions: Symptomatic women with lower a-priori likelihood of breast malignancy (younger age, post-partum, or non-specific visit code) are at a significantly greater risk of delayed diagnosis of cancer. Physicians should be aware of the challenging diagnosis in young women with non-specific symptoms.

scholarly journals Factors associated with concordant estrogen receptor expression at diagnosis and centralized re-assay in a Danish population-based breast cancer study

2011 ◽  
Vol 51 (2) ◽  
pp. 254-261 ◽  
Author(s):  
Deirdre P. Cronin-Fenton ◽  
Ylva Hellberg ◽  
Kristina L. Lauridsen ◽  
Thomas P. Ahern ◽  
Jens Peter Garne ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Population Based ◽  
Receptor Expression ◽  
Estrogen Receptor Expression ◽  
Danish Population ◽  
Cancer Study ◽  
Factors Associated ◽  
Breast Cancer Study

High-early recurrence rate in a cohort of young women with breast cancer in Mexico.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12560-e12560
Author(s):  
Cynthia Villarreal-Garza ◽  
Andrea Becerril Gaitan ◽  
Bryan Vaca-Cartagena ◽  
Fernanda Mesa-Chavez ◽  
Ana Sofia Ferrigno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Recurrence Rate ◽  
Young Women ◽  
Distant Metastases ◽  
Disease Recurrence ◽  
Early Recurrence ◽  
Multivariate Model ◽  
Stage Ii ◽  
Factors Associated ◽  
Node Involvement

e12560 Background: Young women with breast cancer (YWBC) have worse survival outcomes compared to their older counterparts. Even though a higher recurrence rate has been previously documented in this population, there is still limited information regarding the timing, prevalence and type of disease recurrence. This study aims to describe the patterns of early recurrence in Mexican YWBC. Methods: Women aged ≤40 years at diagnosis, accrued in the Joven & Fuerte prospective cohort, with stage I-III BC and having at least a 2-year follow-up were analyzed. Recurrence-free survival (RFS) and overall survival (OS) at 2 years were evaluated using the Kaplan-Meier estimate. Log-rank and Fisher’s exact tests were employed for group comparisons; the Cox regression method was used to identify factors associated with RFS and OS. Results: A total of 210 patients with a median age at diagnosis of 36 years (range: 21-40) were analyzed. Most patients were diagnosed with stage II (50%) and III (39%). Distribution according to molecular subtype was: 50% HR+/HER2-, 26% TNBC, 17% HR+/HER2+, and 7% HR-/HER2+. In total, 31 (15%) patients experienced early disease recurrence. The two BC subtypes with the highest recurrence rate were TNBC (12/54; 22%) and HR+/HER2+ (6/35; 17%), followed by HR+/HER2- (12/106; 11%) and HR-/HER2+ (1/15; 7%). Stage at diagnosis was associated with a higher risk of recurrence (stage III: 21/82 (68%); stage II: 10/94 (32%); p= 0.003). Of the total recurrences, 23% were locorregional and the remaining 77% were distant metastases. The most common sites of distant metastases were lung (46%), bone (38%) and central nervous system (33%). Notably, 50% of distant recurrences affected multiple organs. Overall, RFS at 2 years was 85.2% (95%CI 79.7-89.4). In the univariate analysis, age ( < 35 v ≥35), type of surgery (conservative v mastectomy) and BMI ( < 25 v ≥25 kg/m²) were not significantly associated with RFS. In a multivariate model, node involvement (HR = 2.76; p= 0.044), not receiving chemotherapy (HR = 3.86; p= 0.024) and TNBC (HR = 2.47; p= 0.035) were independently associated with worse RFS. The OS found in this cohort was 92.9% (95%CI 88.4-95.6). In a multivariate model, TNBC (HR = 3.71; p= 0.029) and stage III at diagnosis (HR = 5.55; p= 0.008) were associated with worse OS. Conclusions: This cohort of YWBC experienced a low RFS at 2 years. As previously reported, patients with node involvement and TNBC faced a greater risk of early recurrence. Noteworthy, a high prevalence of distant metastases was observed, with half of them involving > 1 site. Future studies are warranted to elucidate the factors associated with early recurrence in YWBC. In addition, the incorporation of new treatment strategies is urgently needed to improve disease outcomes in this group.

Sign in / Sign up

Export Citation Format

Share Document