scholarly journals Immunotherapy in Adolescents and Young Adults: What Remains in Cancer Survivors?

2021 ◽  
Vol 11 ◽  
Author(s):  
Enrica Teresa Tanda ◽  
Elena Croce ◽  
Francesco Spagnolo ◽  
Lodovica Zullo ◽  
Stefano Spinaci ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Male Fertility ◽  
Scientific Community ◽  
Ad Hoc ◽  
Advanced Disease ◽  
Young Patients ◽  
Adolescent And Young Adult ◽  
Early Disease ◽  
Multiple Neoplasms ◽  
The Impact

Immunotherapy has changed the landscape of treatments for advanced disease in multiple neoplasms. More and more patients are long survivors from a metastatic disease. Most recently, the extension of indications and evidence of efficacy in early disease settings, such as the adjuvant and neoadjuvant setting in breast cancer, lung cancer, glioma, and gastric cancer, places more attention on what happens to patients who survive cancer. In particular, we evaluated what happens in young patients, a population in whom some immune-related effects are still poorly described. Immunotherapy is already a reality in early disease settings and the scientific community is lagging in describing what to expect in adolescent and young adult (AYA) patients. For instance, the impact of these therapies on female and male fertility is not clear, similarly to the interaction that may occur between these drugs and pregnancy. This review aims to highlight these little-known topics that are difficult to evaluate in ad hoc studies.

scholarly journals Real-World Data Related to Non-Metastatic Breast Cancer in Young Women: Experience of a Single Institution

2018 ◽  
Vol 64 (1) ◽  
pp. 45-53
Author(s):  
Juliana Cunha e Silva Ominelli De Souza ◽  
Andrew Sá Nunes ◽  
Jesse Lopes Da Silva ◽  
Aline Coelho Gonçalves ◽  
Suzanne Crocamo Ventilari Da Costa
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Lymph Node ◽  
Young Women ◽  
Advanced Disease ◽  
Young Patients ◽  
Metastatic Breast ◽  
Lymph Node Involvement ◽  
Axillary Lymph ◽  
Node Involvement

Introduction: Breast cancer is the leading cause of cancer-related deaths in women aged 20-59 years. Younger women usually have more aggressive tumors and more advanced disease with larger size and axillary lymph node involvement. There have been few studies assessing the characteristics of breast cancer in very young women. Objective: Evaluate the epidemiological and clinical profile of non-metastatic very young patients with breast cancer. Method: We performed a retrospective analysis to evaluate the epidemiological and clinical profile of non-metastatic breast cancer in patients ≤ 30 years of age treated between 1993 and 2011 at the Brazilian National Cancer Institute José Alencar Gomes da Silva. We evaluated relapse-free survival (RFS) and overall survival (OS). Results: Of the 196 patients evaluated, 181 (90%) had ductal carcinoma, 79 (40%) had high-grade tumors, and 102 (52%) had hormone receptor-positive tumors. 117 patients(60%) had stage III disease at diagnosis. The median age was 29 years (range, 17-30 years). Of 185 patients who underwent surgery, 156 (84.3%) underwent total mastectomy and 171 (92%) underwent axillary lymph node dissection. 119 patients received neoadjuvant chemotherapy, and 14 patients (9.3%) underwent neoadjuvant radiotherapy. After a median follow-up of 81.5 months, 109 patients (55%) had relapsed and 81 (41%) had died. The median RFS and OS were 49.5 months and 134 months, respectively. Lymph node involvement and neoadjuvant chemotherapy were associated with shorter RFS and OS. Conclusion: Breast cancer is uncommon in young patients, especially in those ≤ 30 years of age. We found a predominance of locally advanced disease and worse prognostic pathological characteristics. Despite the aggressive treatment, our patients had worse outcomes than those reported by other authors.

scholarly journals Corrigendum to “The impact of menstruation persistence or recovery after chemotherapy on survival in young patients with hormone receptor negative breast cancer” [Breast 52 (2020) 102–109]

The Breast ◽  
2020 ◽  
Vol 53 ◽  
pp. 221-222
Author(s):  
Mark van Barele ◽  
Bernadette A.M. Heemskerk-Gerritsen ◽  
Helena C. van Doorn ◽  
Marjanka K. Schmidt ◽  
Maartje J. Hooning ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Young Patients ◽  
Cancer Breast ◽  
The Impact

scholarly journals Mastectomy versus conservative surgical treatment: the impact on the quality of life of women with breast cancer

2010 ◽  
Vol 10 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Daniela Francescato Veiga ◽  
Fabíola Soares Moreira Campos ◽  
Leda Marques Ribeiro ◽  
Ivanildo Archangelo Junior ◽  
Joel Veiga Filho ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Physical Functioning ◽  
Negative Impact ◽  
Young Patients ◽  
Conservative Surgery ◽  
Sf 36 ◽  
Significant Difference ◽  
The Impact

OBJECTIVES: to compare the impact of mastectomy and conservative surgery on the quality of life of patients with breast cancer. METHODS: an assessment was made of the quality of life of patients undergoing mastectomy or segmentary mastectomy, at the Pouso Alegre Clinical Hospital, in the Brazilian State of Minas Gerais, using SF-36. The patients were grouped by age (<50 years and >50 years) and years of schooling (<8 years and >8 years). The Mann-Whitney test was used to compare the groups with regard to the age and schooling domains of SF-36. RESULTS: a significant difference between the two groups was found in the domains of "physical functioning" (p=0.04) and "pain" (p=0.01): with the patients undergoing a mastectomy registering the worst scores. Young patients who had undergone a mastectomy displayed the worst quality of life in terms of "physical functioning" (p=0.03), "pain" (p=0.01) and "social functioning" (p=0.01); those undergoing conservative surgery aged over 50 years scored worst on "role emotional" (p=0.05). Patients undergoing a mastectomy with lower levels of schooling scored lower in "physical functioning" (p=0.01), "role physical" (p=0.05) and "pain" (p=0.05). Among those who had attended school for more than eight years, those having undergone a mastectomy scored less in the "pain" domain (p=0.04). CONCLUSIONS: patients who had undergone a mastectomy had worse results in the physical component of the evaluation of quality of life and this negative impact was more strongly felt among younger patients and those with lower levels of schooling.

Breast Cancer Stage at Presentation in Ohio: The Effect of Medicaid Expansion and the Affordable Care Act

2020 ◽  
Vol 86 (3) ◽  
pp. 195-199
Author(s):  
Dan Kirkpatrick ◽  
Margaret Dunn ◽  
Rebecca Tuttle
Keyword(s):  
Breast Cancer ◽  
Affordable Care Act ◽  
Advanced Disease ◽  
Disease Stage ◽  
Cancer Stage ◽  
Medicaid Expansion ◽  
Cancer Data ◽  
Before And After ◽  
The Affordable Care Act ◽  
The Impact

Patients presenting with localized breast cancer have a five-year survival of 99 per cent, whereas survival falls to 27 per cent in advanced disease. This obviates the importance of early diagnosis and treatment. Our study evaluates the impact of Ohio's Medicaid expansion and the passage of the Affordable Care Act (ACA) on the stage at which Ohioans were diagnosed with breast cancer. Data were collected for 3056 patients presenting with breast cancer between 2006 and 2016 in the Dayton area. Patients were divided into groups based on cancer stage. The percentage of patients presenting with advanced disease (stage 3 or 4) was compared both before and after ACA implementation and Ohio Medicaid expansion. These results were also compared with statewide data maintained by the Ohio Department of Health. Compared with pre-ACA, the number of uninsured patients post-ACA was noted to fall 83 per cent, the number of patients presenting with Medicaid increased by five times, and the proportion of patients younger than 65 years presenting with breast cancer increased by approximately 7 per cent. These changes notwithstanding, no difference was identified in the percentage of patients presenting with advanced breast cancer before and after ACA implementation or Ohio Medicaid expansion ( P = 0.56). Statewide data similarly demonstrated no change ( P = 0.88). Improved insurance access had a smaller-than-anticipated impact on the stage at which Ohioans presented with breast cancer. As significant morbidity and mortality can be avoided by earlier presentation, additional research is appropriate to identify factors affecting patients’ decision to seek breast cancer screening and care.

scholarly journals Impact of Different Modules of 21-Gene Assay in Early Breast Cancer Patients

2021 ◽  
Author(s):  
Mengdi Chen ◽  
Deyue Liu ◽  
Weilin Chen ◽  
Weiguo Chen ◽  
Kunwei Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Young Patients ◽  
Breast Cancer Patients ◽  
Old Patients ◽  
Gene Assay ◽  
Risk Patients ◽  
Group A ◽  
Group B ◽  
The Impact

Abstract Background: Young patients were under-evaluated in the construction and validation of the 21-gene Assay Recurrence Score (RS). Previous evidence suggested that RS performed differently according the ages of patients. Our study aimed to explore the molecular driving patterns in patients of different ages.Methods: A total of 1,078 estrogen receptor (ER)-positive breast cancer patients between Jan 2009 and Mar 2017 from Shanghai Jiao Tong University Breast Cancer Data Base were divided into three subgroups: Group A, ≤40y and premenopausal (n=97); Group B, >40y and premenopausal (n=284); Group C, postmenopausal (n=697). The correlation of RS and its modules and the variance of RS modules was explored.Results: Estrogen module had a stronger correlation with RS in patients >40y (ρ = -0.76 in Group B and -0.79 in Group C) compared with patients ≤40y (ρ = -0.64). Contrarily, the correlation between RS and invasion group was weaker in patients >40y (ρ = 0.29 in Group B and 0.25 in Group C) than in patients ≤40y (ρ = 0.44). The proliferation module contributed most to the variance in young patients (37.3%) while ER module contributed most in old patients (54.1% in Group B and 53.4% in Group C). For RS >25, proliferation module was the leading driver in all three subgroups (ρ = 0.38, 0.53 and 0.52 in Group A, B and C) while estrogen module had a weaker association with RS. The negative impact of ER related features on RS was stronger in clinical low-risk patients while the positive effect of proliferation module was stronger in clinical high-risk patients.Conclusions: RS was primarily driven by estrogen module in patients regardless of age, but the proliferation module had a stronger impact on RS in patients ≤40y than in those >40y. The impact of modules varied in patients with different genetic and clinical risk.

scholarly journals The impact of menstruation persistence or recovery after chemotherapy on survival in young patients with hormone receptor negative breast cancer

The Breast ◽  
2020 ◽  
Vol 52 ◽  
pp. 102-109
Author(s):  
Mark van Barele ◽  
Bernadette A.M. Heemskerk-Gerritsen ◽  
Helena C. van Doorn ◽  
Marjanka K. Schmidt ◽  
Maartje J. Hooning ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Young Patients ◽  
The Impact

scholarly journals Clinical behavior and outcomes of breast cancer in young women with germline BRCA pathogenic variants

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Matteo Lambertini ◽  
Marcello Ceppi ◽  
Anne-Sophie Hamy ◽  
Olivier Caron ◽  
Philip D. Poorvu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Hormone Receptor ◽  
Young Patients ◽  
Disease Free Survival ◽  
Distant Recurrence ◽  
Hormone Receptor Status ◽  
Second Primary ◽  
Clinical Behavior ◽  
Receptor Status ◽  
The Impact

AbstractYoung breast cancer (BC) patients carrying a germline BRCA pathogenic variant (mBRCA) have similar outcomes as non-carriers. However, the impact of the type of gene (BRCA1 vs. BRCA2) and hormone receptor status (positive [HR+] vs. negative [HR−]) on clinical behavior and outcomes of mBRCA BC remains largely unknown. This is an international, multicenter, hospital-based, retrospective cohort study that included mBRCA patients diagnosed, between January 2000 and December 2012, with stage I–III invasive early BC at age ≤40 years. From 30 centers worldwide, 1236 young mBRCA BC patients were included. Among 808 and 428 patients with mBRCA1 or mBRCA2, 191 (23.6%) and 356 (83.2%) had HR+tumors, respectively (P < 0.001). Median follow-up was 7.9 years. Second primary BC (P = 0.009) and non-BC malignancies (P = 0.02) were more frequent among mBRCA1 patients while distant recurrences were less frequent (P = 0.02). Irrespective of hormone receptor status, mBRCA1 patients had worse disease-free survival (DFS; adjusted HR = 0.76, 95% CI = 0.60–0.96), with no difference in distant recurrence-free interval (DRFI) and overall survival (OS). Patients with HR+ disease had more frequent distant recurrences (P < 0.001) and less frequent second primary malignancies (BC: P = 0.005; non-BC: P = 0.18). No differences in DFS and OS were observed according to hormone receptor status, with a tendency for worse DRFI (adjusted HR = 1.39, 95% CI = 0.94–2.05) in patients with HR+ BC. Type of mBRCA gene and hormone receptor status strongly impact BC clinical behavior and outcomes in mBRCA young patients. These results provide important information for patients’ counseling on treatment, prevention, and surveillance strategies.

scholarly journals What was the impact of COVID-19 on Adolescent and Young Adult cancer care and their wellbeing? Results from a cross-sectional online survey conducted in the early stages of the pandemic

2020 ◽  
Author(s):  
Urska Kosir ◽  
Maria Elizabeth Loades ◽  
Jennifer Wild ◽  
Milan Wiedemann ◽  
Alen Krajnc ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Young People ◽  
Cancer Patients ◽  
Cancer Care ◽  
Information Needs ◽  
Online Survey ◽  
Young Patients ◽  
Adolescent And Young Adult ◽  
Cross Sectional ◽  
The Impact

Background: Due to the global spread of COVID-19, oncology departments across the world rapidly adapted their cancer care protocols, balancing the risk of delaying cancer treatments and risk of COVID-19 exposure. COVID-19 and associated changes may have an impact on psycho-social functioning of cancer patients and survivors. We wanted to understand the impact of COVID-19 pandemic on young people living with and beyond cancer.Method: In this cross-sectional study, we surveyed 177 individuals, aged 18 - 39 years, about the impact of COVID-19 on their cancer care and psychological wellbeing. Participants also reported their information needs relating to COVID-19. Responses were summarized using content analysis approach. Results: This is the first study to examine psychological functioning of young patients and survivors during the first weeks of the COVID-19 pandemic. Close to a third of respondents reported increased levels of psychological distress, and as many as 60% reported feeling more anxious than they did prior to COVID-19. More than half also wanted more information tailored to them as young cancer patients. Conclusions: The COVID-19 pandemic is rapidly evolving and changing the landscape of cancer care. Young people living with cancer are a unique population and might be more vulnerable during this time compared to their healthy peers. There is a need to screen for psychological distress and attend to young people whose cancer care has been delayed. As the lockdown begins to ease, the guidelines about cancer care should be updated according to this population’s needs.

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