ESO–ESMO fifth international consensus guidelines for breast cancer in young women (BCY5)

Paluch‐Shimon, Shani; Cardoso, Fátima; Partridge, Ann H.; Abulkhair, Omalkhair; Azim, Hatem A.; Bianchi-Micheli, G.; Cardoso, M.J.; Curigliano, Giuseppe; Gelmon, Karen A.; Gentilini, Oreste; Harbeck, Nadia; Kaufman, Bella; Kim, S.B.; Liu, Q.; Merschdorf, J.; Poortmans, Philip; Pruneri, Giancarlo; Senkus, Elżbieta; Sirohi, Bhawna; Španić, Tanja; Sulosaari, Virpi; Peccatori, Fedro Alessandro; Pagani, Olivia

doi:10.1016/j.annonc.2022.07.007

Cited by 93 publications

(75 citation statements)

References 162 publications

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“…According to the molecular classi cation of BC, young breast cancers accounted for a higher proportion of basal-like tumors (34.3%) [46] . Among ER-negative BC types, younger women with breast cancer are characterized by higher proportion of tumors with aggressive phenotypes and more unfavorable longer-term outcome than older counterparts [47] . Although young patients with TNBC have more tumor immune cells in ltration and strong immune adaptability [48] , there is still a lack of effective treatment data of immune-therapy in this population.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Effect of Ruai-Sanyin formula maintenance therapy after completion of standard adjuvant treatment on survival in women with early-stage triple negative breast cancer: A multicenter prospective cohort study

Wang

Sun

Qin

et al. 2022

Preprint

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Background Ruai-sanyin formula (RASYF) is composed of a variety of anticancer herbs. It is widely used in the treatment of triple negative breast cancer (TNBC) and has proved to inhibit tumor growth and lung metastasis in animal models, but there is no evidence for clinical application in the real world. Methods We conducted this prospective cohort study at 5 research centers in China from November 2016 to December 2018. RASYF was set as an exposure factor. TNBC patients within 3 months after completion of standard adjuvant treatment were included. The exposed group received RASYF treatment, while the non-exposed group received observation. The primary end point was disease-free survival (DFS). Secondary end points included, overall survival (OS), distant disease-free survival (DDFS), relapse-free survival (RFS), QLQ-BR23 assesses quality of life in patients and adverse events. Results A total of 613 eligible patients with operable TNBC were enrolled, of which 588 were included in the Full Protocol Set. At a median follow-up of 48 months, DFS time was longer in those assigned to RASYF compared with observation (3-year DFS, 89.6% vs. 83.5%, [HR = 0.61, 95%CI (0.39-0.95)]; P = 0.03). Similar outcomes were observed for RFS (3-year RFS, 92.1% vs. 85.9%, HR = 0.55, [95% CI, 0.34-0.91]; P = 0.02). However, there was no statistically significant difference in OS and DDFS between the groups. In exploratory subgroup analysis, RASYF benefits were greater in patients with age under the 40 (3-year DFS, 88.4% vs. 76.1%, [HR = 0.45, 95%CI (0.21-0.95)]; P = 0.03). And RASYF is helpful to the improvement of postoperative quality of life. Comparing to the observation group, RASYF increased the mean CFB of BR23 scores in body image (12.34 vs. 8.76, P = 0.03)，sexual function (11.79 vs. 9.23, P <0.01) , future perspective (9.90 vs. 6.53, P= 0.04), and decreased the scores of systemic therapy side effects (-12.41 vs. -9.24, P = 0.01). Safety analysis showed that RASYF caused major adverse reactions including impaired liver function (4.0%) and stomach pain (6.1%), but the overall security is controllable. Conclusion RASYF supplementation for 2 years after standard adjuvant chemoradiotherapy has certain clinical significance in preventing recurrence and metastasis and improving the quality of life of patients with early TNBC. Trial registration ClinicalTrials.gov: NCT03332368 Registered 6 November, 2017 (retrospectively registered)

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Effect of Ruai-Sanyin formula maintenance therapy after completion of standard adjuvant treatment on survival in women with early-stage triple negative breast cancer: A multicenter prospective cohort study

Wang

Sun

Qin

et al. 2022

Preprint

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“…Considering that the median age at diagnosis in patients with a pregnancy after breast cancer was 30 years, the risk of treatment-induced premature ovarian insufficiency and associated infertility can be considered relatively low in these patients . Nevertheless, all young women diagnosed with cancer during reproductive years should be offered the opportunity to access fertility preservation strategies before initiating systemic anticancer therapies . This is particularly relevant in young BRCA carriers considering their possible interest in accessing preimplantation genetic diagnosis for monogenic diseases, as well as the potential increased risk of chemotherapy-induced premature ovarian insufficiency compared with age-matched noncarriers .…”

Section: Discussionmentioning

confidence: 99%

Pregnancy After Breast Cancer in Young BRCA Carriers

Lambertini,

Blondeaux,

Agostinetto

et al. 2024

JAMA

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ImportanceYoung women with breast cancer who have germline pathogenic variants in BRCA1 or BRCA2 face unique challenges regarding fertility. Previous studies demonstrating the feasibility and safety of pregnancy in breast cancer survivors included limited data regarding BRCA carriers.ObjectiveTo investigate cumulative incidence of pregnancy and disease-free survival in young women who are BRCA carriers.Design, Setting, and ParticipantsInternational, multicenter, hospital-based, retrospective cohort study conducted at 78 participating centers worldwide. The study included female participants diagnosed with invasive breast cancer at age 40 years or younger between January 2000 and December 2020 carrying germline pathogenic variants in BRCA1 and/or BRCA2. Last delivery was October 7, 2022; last follow-up was February 20, 2023.ExposurePregnancy after breast cancer.Main Outcomes and MeasuresPrimary end points were cumulative incidence of pregnancy after breast cancer and disease-free survival. Secondary end points were breast cancer–specific survival, overall survival, pregnancy, and fetal and obstetric outcomes.ResultsOf 4732 BRCA carriers included, 659 had at least 1 pregnancy after breast cancer and 4073 did not. Median age at diagnosis in the overall cohort was 35 years (IQR, 31-38 years). Cumulative incidence of pregnancy at 10 years was 22% (95% CI, 21%-24%), with a median time from breast cancer diagnosis to conception of 3.5 years (IQR, 2.2-5.3 years). Among the 659 patients who had a pregnancy, 45 (6.9%) and 63 (9.7%) had an induced abortion or a miscarriage, respectively. Of the 517 patients (79.7%) with a completed pregnancy, 406 (91.0%) delivered at term (≥37 weeks) and 54 (10.4%) had twins. Among the 470 infants born with known information on pregnancy complications, 4 (0.9%) had documented congenital anomalies. Median follow-up was 7.8 years (IQR, 4.5-12.6 years). No significant difference in disease-free survival was observed between patients with or without a pregnancy after breast cancer (adjusted hazard ratio, 0.99; 95% CI, 0.81-1.20). Patients who had a pregnancy had significantly better breast cancer–specific survival and overall survival.Conclusions and RelevanceIn this global study, 1 in 5 young BRCA carriers conceived within 10 years after breast cancer diagnosis. Pregnancy following breast cancer in BRCA carriers was not associated with decreased disease-free survival.Trial RegistrationClinicalTrials.gov Identifier: NCT03673306

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“…Available options for adjuvant endocrine therapy in premenopausal women include ovarian function suppression (OFS) in combination with an aromatase inhibitor or tamoxifen, or tamoxifen alone. Treatment should be tailored on individual risk of recurrence and patients' characteristics [95][96][97]. Addition of OFS to endocrine therapy has proven effective in reducing risk of recurrence and death in premenopausal women diagnosed with highrisk disease [98].…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

The Future of Breast Cancer Research in the Survivorship Field

et al. 2023

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Prevalence of survivors of breast cancer has been steadily increasing in the last 20 years. Currently, more than 90% of women diagnosed with earlystage breast cancer are expected to be alive at 5 years from diagnosis thanks to early detection and breakthrough innovations in multimodal treatment strategies. Alongside this advancement in clinical outcomes, survivors of breast cancer might experience several specific challenges and present with unique needs. Survivorship trajectories after diagnosis and treatment of breast cancer can be significantly impacted by long-lasting and severe treatment-related side effects, including physical problems, psychological distress, fertility issues in young women, and impaired social and

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ESO–ESMO fifth international consensus guidelines for breast cancer in young women (BCY5)

Cited by 93 publications

References 162 publications

WITHDRAWN: Effect of Ruai-Sanyin formula maintenance therapy after completion of standard adjuvant treatment on survival in women with early-stage triple negative breast cancer: A multicenter prospective cohort study

WITHDRAWN: Effect of Ruai-Sanyin formula maintenance therapy after completion of standard adjuvant treatment on survival in women with early-stage triple negative breast cancer: A multicenter prospective cohort study

Pregnancy After Breast Cancer in Young BRCA Carriers

The Future of Breast Cancer Research in the Survivorship Field

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