Breast Cancer in Young Women in Latin America: An Unmet, Growing Burden

Abstract

Background. Breast cancer (BC) is the leading cause of malignancy-related deaths among women aged Յ45 years. There are unexplored and uncertain issues for BC in this particular group in Latin America. The aim of this study is to evaluate BC incidence and mortality among young women and related clinicopathological and survivorship aspects in this region. Materials and Methods. Data were obtained from Globocan 2008 and the International Agency for Research on Cancer's Cancer Incidence in Five Continents series plus databases. We requested collaborationfromthe12differentnationalcancerin-stitutes in Latin America through SLACOM, the Latin American andCaribbeanSocietyofMedicalOncology,andconductedasystematic literature review to obtain local data regarding the prevalence of BC among young women and their characteristics, outcomes, and survivorship-related issues. Results. BC incidence and mortality proportions for Latin American women aged Ͻ44 years were higher when compared with those of developed countries (20% vs. 12% and 14% vs. 7%, respectively). We found only a few Latin American series addressing this topic, and prevalence varied between 8% and 14%. Stage II and III disease, high histological grade, and triple-negative and HER2 BC were features frequently observed among young Latin American BC patients. Conclusion. The rising incidence and mortality of BC in young Latin American women is a call to action in the region. It is necessary to monitor the epidemiological and clinical data through reliable cancer registries and to consider the implementation of protocols for education of patients and health professionals. This unmet, growing burden must be considered as a top priority of the national programs in the fight against BC, and models of specialized units should be implemented for this particular group of patients to provide better care for this emergent challenge. The Oncologist 2013;18: 1285-1297 Implications for Practice: This review illustrates that breast cancer (BC) among Latin American women is a growing burden throughout the region. The increased proportion of BC cases in young women is important because their diagnoses and tumor behavior are usually more aggressive than in their older counterparts. The findings of this study reveal that there is scarce information regarding this matter in Latin American countries, especially concerning the particular effects and complications that this group of women face during and after treatment. Also, there are no specific clinical or educational programs that focus on this population. A call to action from health policy planners, medical providers, researchers, BC patients, families, and the community in general is deserved for better care of this emergent challenge.

Disparities in Breast Cancer Characteristics in Mexico

“…Most series in our country come from large public health institutions, such as the National Institute of Cancer. In the present series we found that patient age does not differ from that of women attended to in public institutions, and this is corroborated with observations already published in other series that have established that, on average, breast cancer onset in our country occurs up to one decade earlier than in the USA or Europe 5,10 . The infiltrating canalicular histologic type is not different from that reported by national and international series; however, the immunophenotype was significantly different, in particular with a lower proportion of the most aggressive subtypes, namely, pure HER2 and triple-negative, although in the latter the difference was not statistically significant with regard to the InCan series (12 vs. 17%).…”

The Epidemiological Challenges of Breast Cancer among Premenopausal Women in Limited Resource Settings

“…The early presentation of breast cancer in developing countries has been attributed to the younger demographic composition of these countries 5,11 . For example, a retrospective study was performed at Ahmadu Bello University Teaching Hospital in Nigeria, a country in which approximately 49% of the population is younger than 15 years of age 12 .…”

Breast Cancer Thirty Years Later: A Comparative Study between A 1983-1984 AND A 2012-2013 Cohorts of Argentine Women

“…Despite the assertion that BC is a leading cause of death and disability among women, especially young women [21,22] and that the BC occurs increasingly in younger women in developing countries [23][24][25][26] [28][29][30] even against the recommendations of international medical societies and health authorities regarding the upper age limits for screening [31][32][33]. This would allow more BC grouped under the concept of "overdiagnosis" to be diagnosed [34][35][36].…”