Objective To describe clinical and information needs, identify unmet support services and guide interventions for young breast cancer (BC) patients in Mexico. Methods Cross‐sectional, qualitative study, using interpretive description methodology. Patients with initial BC diagnosis within 6–12 months prior to enrolment, ≤40 years old and literate were included in focus groups. Results Twenty‐nine patients were included. Expressed needs were classified into the following categories: (a) understanding diagnosis and treatment; (b) treatment side effects; and (c) time, source and communication means. Patients felt their medical team did not provide enough information regarding diagnosis, treatment and relevant side effects related to fertility, menopause and sexuality. Lack of information fuelled uncertainty, distress, anxiety and fear, and could negatively influence treatment decisions. Patients wished that news be communicated considering their own attitude regarding the disease and providing psychological support when necessary, including partners, relatives and friends. They recommended that information should be delivered with an empathic and personalised approach, with take‐home educational material to help them recall, comprehend and/or expand verbal information received during medical appointments. Conclusions This study provides valuable insight to increase attention on unmet needs of young BC patients and to improve doctor–patient communication to ensure better care.

Summary:Non-myeloablative regimens have been proven to allow engraftment following allogeneic stem cells transplantation (allo-SCT) with minimal procedure-related toxicity. Conventional allo-SCT may produce remissions in patients with relapsed and refractory lymphoid malignancies (LM) but these good results may be achieved at the cost of high treatment-related morbidity and mortality. Application of allo-SCT using less intensive regimens may temper the frequency of these complications, allowing a potent graft-versus-tumor effect (GVT). We present our data on 11 patients with LM receiving allo-SCT with a reduced regimen. Ten patients had received previous high-dose therapy, and were at high risk for toxicity, thus precluding the use of allo-SCT. A fludarabine and low-dose busulfan combination facilitated engraftment while exerting GVT. Hematological recovery was quick, and full donor T cell chimerism preceded acute GVHD. GVHD and infections were the major problems. Spontaneous acute GVHD occurred in eight patients (72%). Five patients (45%) achieved complete remission, and the GVT effect was closely associated with GVHD. These results support the concept that GVT is effective against LM in patients who have been heavily pretreated. Further studies are needed to investigate strategies to generate more specific alloreactive effects providing optimal GVT and an acceptable risk of GVHD and infections. Bone Marrow Transplantation the alloreactivity against host tumor cells. 1,2 Non-myeloablative and reduced conditioning regimens have recently been proven to allow engraftment following allo-SCT with minimal procedure-related toxicity in patients with advanced disease. 3 The immune reaction between donorderived immunocompetent T lymphocytes and host-type tumor cells has been well established to be the major antitumor agent in allo-SCT. 1 Evidence supporting the socalled graft-versus-tumor (GVT) effect includes the higher risk of relapse following T cell-depleted or syngeneic transplantation. 4,5 Furthermore, donor lymphocyte infusions (DLI) may re-induce remission in many patients relapsing after allo-SCT. 6 New approaches using non-myeloablative and reduced conditioning regimens aim to extend the use of allo-SCT to patients who are ineligible for high-dose chemotherapy or total body irradiation by prioritizing and increasing the immunosuppressive aspect of the preparation.Multiple myeloma (MM) is a lymphoid malignancy (LM) with a median survival of 3 years. Despite the development of numerous conventional chemotherapy regimens, there has been little progress in improving the survival of patients with MM. High-dose chemotherapy with autologous stem cell transplantation (ASCT) can result in prolonged survival, 7 but unfortunately, few, if any, patients with MM who receive ASCT are cured. 8 Only allo-SCT is curative in MM. However, the very high transplant-related morbidity and mortality limit the application of allo-SCT to younger patients. Allo-SCT has also produced prolonged remissions in patients with relapsed and ref...

PURPOSE The pilot-phase report of the Joven & Fuerte prospective cohort broadly characterizes and assesses the needs of Mexican young women with breast cancer (YWBC). PATIENTS AND METHODS Women age ≤ 40 years with nonmetastatic primary breast cancer were consecutively accrued from 2 hospitals. Data were collected at the first/baseline oncology visit and 2 years later using a sociodemographic survey, European Organisation for Research and Treatment of Cancer Quality-of-Life (QOL) Questionnaire Core 30 (QLQ-C30) and Breast Cancer–Specific QOL Questionnaire (QLQ-BR23), Hospital Anxiety and Depression Scale (HADS), Female Sexual Functioning Index (FSFI), Sexual Satisfaction Inventory, and patients’ medical records. Pearson χ2 and 2-sided t tests were used for statistical analysis. An unadjusted P value < .05 was considered significant. RESULTS Ninety patients were included, all with government health care coverage. Most had low monthly household incomes (98%) and at least a high school education (59%). There was a considerable prevalence of unpartnered patients (36%) and unmet parity (25%). Patients’ most common initial symptom was a palpable mass (84%), and they were most frequently diagnosed with stage III disease (48%), with 51% having had a physician visit ≤ 3 months since detection but 39% receiving diagnosis > 12 months later. At baseline, 66% of patients were overweight/obese, and this proportion had significantly increased by 2 years ( P < .001). Compared with baseline, global QLQ-C30 had improved significantly by 2 years ( P = .004), as had HADS-Anxiety ( P < .001). However, both at baseline and at 2 years, nearly half of patients exhibited FSFI sexual dysfunction. CONCLUSION These preliminary findings demonstrate that YWBC in Mexico have particular sociodemographic and clinicopathologic characteristics, reinforcing the necessity to further describe and explore the needs of these young patients, because they may better represent the understudied and economically vulnerable population of YWBC in limited-resource settings.

In countries such as Mexico, infrastructure and financial drawbacks limit the implementation of effective screening mammography programs. This article presents a novel and effective alternative to optimize resources and reduce health system intervals, so that patients in limited-resource settings can have access to prompt quality care. This strategy for early breast cancer detection focused efforts in prioritizing symptomatic women and those with abnormal breast imaging studies. This article presents novel information that will be useful for the development of effective early breast cancer detection with a focus on opportunistic rather than population-screening mammography in low-resource settings.