Breast Cancer in Young Women Oreste Gentilini Ann H. Partridge Olivia Pagani Editors 123 Breast Cancer in Young Women Oreste Gentilini • Ann H. Partridge Olivia Pagani Editors Breast Cancer in Young Women Editors Oreste Gentilini Ann H. Partridge Breast Unit, San Raffaele University and Dana–Farber Cancer Institute Research Hospital Department of Medical Oncology Milan Harvard Medical School Italy Boston, MA USA Olivia Pagani Geneva University Hospitals Swiss Group for Clinical Cancer Research (SAKK) Institute of Oncology of Southern Switzerland Bellinzona Switzerland ISBN 978-3-030-24761-4 ISBN 978-3-030-24762-1 (eBook) https://doi.org/10.1007/978-3-030-24762-1 © Springer Nature Switzerland AG 2020 This work is subject to copyright. 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Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Contents 1 Epidemiology ������������������������������������������������������������������������������������ 1 Philip D. Poorvu and Ann H. Partridge 2 Young Age and Breast Cancer Biology ������������������������������������������ 13 Hamdy A. Azim, Bastien Nguyen, and Hatem A. Azim Jr 3 Imaging to Improve Diagnosis of Breast Cancer in Young Women . 23 Tanja Gagliardi 4 Establishing a Program for Young Women at High Risk for Breast Cancer �������������������������������������������������������������������� 35 Soley Bayraktar and Banu Arun 5 Locoregional Management of Hereditary Breast Cancer ������������ 47 Maria João Cardoso 6 Systemic Therapies of Young Breast Cancer Patients at High Genetic Risk ������������������������������������������������������������������������ 55 Shani Paluch-Shimon, Bella Kaufman, and Ella Evron 7 Surgical Management of Breast Cancer in Young Women ���������� 69 Rosa Di Micco and Oreste Gentilini 8 Radiation Therapy: Special Issues When Treating Young Women with Breast Cancer . 79 Elżbieta Senkus 9 Timing and Type of Breast Reconstruction in Young Breast Cancer Patients �������������������������������������������������������������������� 89 Rosa Di Micco and Oreste Gentilini 10 Tailoring Chemotherapy and Biological Treatment in Young Patients with EBC ���������������������������������������������������������������� 99 Dario Trapani and Giuseppe Curigliano 11 Endocrine Treatment of Young Patients with EBC . 113 Olivia Pagani v vi Contents 12 Management of Advanced Breast Cancer in Young Women: What’s New in Systemic Treatment ��������������������������������127 Simona Volovat, Joana Mourato Ribeiro, Assia Konsoulova, Shani Paluch-Shimon, and Fatima Cardoso 13 Breast Cancer During Pregnancy . 143 Sibylle Loibl and Sabine Seiler 14 Sexual Health and Body Image After Breast Cancer . 155 Clara Hungr and Sharon Bober 15 Fertility Preservation and Pregnancy After Breast Cancer . 167 Matteo Lambertini and Fedro A. Peccatori 16 Lifestyle Changes and Prevention: Unique Issues for Young Women . 177 Nathalie Levasseur, Rinat Yerushalmi, and Karen A. Gelmon 17 Supportive Care and Psycho- oncology Issues During and Beyond Diagnosis and Treatment ��������������������������������������������197 Luzia Travado and Julia H. Rowland Contributors Banu Arun Department of Breast Medical Oncology and Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA Hamdy A. Azim Department of Clinical Oncology, Cairo University Hospital, Cairo, Egypt Hatem A. Azim Jr Division of Hematology/Oncology, Department of Internal Medicine, American University of Beirut (AUB), Beirut, Lebanon Soley Bayraktar Biruni Univeristy School of Medicine, Protokol Yolu, Istanbul, Turkey Sharon Bober Dana–Farber Cancer Institute, Boston, MA, USA Fatima Cardoso Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal Maria João Cardoso Breast Unit, Champalimaud Clinical Center/ Champalimaud Foundation, Lisbon, Portugal Giuseppe Curigliano IEO, European Institute of Oncology IRCCS, Milano, Italy Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy Ella Evron Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel Tanja Gagliardi University of Aberdeen, Aberdeen, UK Karen A. Gelmon BC Cancer Agency, Vancouver Cancer Centre, Vancouver, BC, Canada Oreste Gentilini Breast Unit, San Raffaele University and Research Hospital, Milan, Italy Clara Hungr Cambridge Health Alliance, Cambridge, MA, USA Bella Kaufman Breast Oncology Institute, Sheba Medical Centre, Ramat Gan, Israel vii viii Contributors Assia Konsoulova Medical Oncology Clinic, University Hospital Sveta Marina, Varna, Bulgaria Matteo Lambertini Department of Medical Oncology, Clinica di Oncologia Medica, Policlinico San Martino-IST, University of Genova, Genoa, Italy Nathalie Levasseur BC Cancer Agency, Vancouver Cancer Centre, Vancouver, BC, Canada Sibylle Loibl German Breast Group, Neu-Isenburg, Germany Centrum für Hämatologie und Onkologie Bethanien, Frankfurt am Main, Germany Rosa Di Micco Breast Unit, San Raffaele University and Research Hospital, Milan, Italy Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy Bastien Nguyen Breast Cancer Translational Research Laboratory (BCTL), Institut Jules Bordet, UniversitéLibre de Bruxelles (ULB), Brussels, Belgium Olivia Pagani Institute of Oncology of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), and International Breast Cancer Study Group (IBCSG), Lugano, Viganello, Switzerland Shani Paluch-Shimon Breast Oncology Unit, Shaare Zedek Medical Centre, Jerusalem, Israel Ann H. Partridge Dana–Farber Cancer Institute and Harvard Medical School, Boston, MA, USA Fedro A. Peccatori Fertility and Procreation Unit, Division of Gynecologic Oncology, European Institute of Oncology, Milan, Italy Philip D. Poorvu Dana–Farber Cancer Institute and Harvard Medical School, Boston, MA, USA Joana Mourato Ribeiro Breast Unit, Champalimaud Clinical Center/ Champalimaud Foundation, Lisbon, Portugal Julia H. Rowland Smith Center for Healing and the Arts, Washington, DC, USA Department of Psychiatry, Georgetown University School of Medicine, Washington, DC, USA Sabine Seiler German Breast Group, Neu-Isenburg, Germany Elżbieta Senkus Department of Oncology & Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland Dario Trapani IEO, European Institute of Oncology IRCCS, Milano, Italy Department of Oncology and Hemato-Oncology, University of Milano, Milan, Italy Contributors ix Luzia Travado Psycho-Oncology, Neuropsychiatry Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon, Portugal Simona Volovat Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal Rinat Yerushalmi Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel Epidemiology 1 Philip D. Poorvu and Ann H. Partridge 1.1 Incidence and Time Trends tieth century. As HRT use diminished abruptly in the early 2000s, rates of breast cancer subse- Breast cancer is the most common malignancy quently declined [7]. While some figures have among women, with more than 1.3 million new suggested a slight increase of 0.6% per year from breast cancers diagnosed annually worldwide, 1994 to 2012 [2], the incidence of breast can- and the second leading cause of cancer death cer among young women has remained mostly among women [1]. The disease is largely diag- stable over the past several decades, presum- nosed in older women, with a median age at ably because young women were not subject diagnosis of 61 [2], and less than 7% of cases to the factors that drove changes in incidence are diagnosed among young women, includ- among older women [3, 4]. While one SEER ing about 1% prior to age 30 and 2.5% prior analysis found a small increase in the incidence to age 35 [3]. The risk to an individual woman of de novo metastatic breast cancer (1.5–2.9 is about 1 in 1500 by age 30 and 1 in 200 by cases/100,000 women from 1976 to 2009), this age 40 [3]. Although there is a higher incidence may be explained by improvements in the abil- among young women in developed countries, ity to detect distant disease using cross-sectional there is fairly limited variation across the world, imaging and differential use of such imaging in particularly as compared with older women young women in particular over time [8]. among whom the