Review
. 2014 Dec;16(4).
doi: 10.1186/s13058-014-0427-5.

Biology of breast cancer in young women

Hatem A Azim  Ann H Partridge  
  • PMID: 25436920
  •     62 References
  •     84 citations

Abstract

Breast cancer arising at a young age is relatively uncommon, particularly in the developed world. Several studies have demonstrated that younger patients often experience a more aggressive disease course and have poorer outcome compared to older women. Expression of key biomarkers, including endocrine receptors, HER2 and proliferation markers, appears to be different in younger patients and young women are more likely to harbor a genetic predisposition. Despite these differences, little research to date has focused on the biology of these tumors to refine prognosis, and potentially direct treatment strategies, which remain similar to those offered to older patients. Accumulating evidence suggests the differences in breast stroma in younger patients and changes that occur with pregnancy and breastfeeding likely contribute to the different biology of these tumors. Reproductive behaviors appear to impact the biology of tumors developing later in life. In addition, tumors arising during or shortly following pregnancy appear to exhibit unique biological features. In this review, we discuss our emerging understanding of the biology of breast cancer arising at a young age at both the pathologic and the genomic level. We elucidate the potential role of genomic signatures, the impact of pregnancy and breastfeeding on breast cancer biology, and how even current knowledge might advance the clinical management of young breast cancer patients.

Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers.
Joanne Kotsopoulos, Jan Lubinski, +19 authors, Hereditary Breast Cancer Clinical Study Group.
Breast Cancer Res, 2012 Mar 13; 14(2). PMID: 22405187    Free PMC article.
Prognosis of pregnancy-associated breast cancer: a meta-analysis of 30 studies.
Hatem A Azim, Luigi Santoro, +3 authors, Fedro A Peccatori.
Cancer Treat Rev, 2012 Jul 13; 38(7). PMID: 22785217
Review.
Understanding the biology of triple-negative breast cancer.
C Criscitiello, H A Azim, +2 authors, C Sotiriou.
Ann Oncol, 2012 Oct 04; 23 Suppl 6. PMID: 23012296
Review.
Phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin pathway inhibition: a breakthrough in the management of luminal (ER+/HER2-) breast cancers?
Dimitrios Zardavas, Debora Fumagalli, Sherene Loi.
Curr Opin Oncol, 2012 Sep 11; 24(6). PMID: 22960556
Review.
CHEK2*1100delC heterozygosity in women with breast cancer associated with early death, breast cancer-specific death, and increased risk of a second breast cancer.
Maren Weischer, Børge G Nordestgaard, +66 authors, Stig E Bojesen.
J Clin Oncol, 2012 Oct 31; 30(35). PMID: 23109706    Free PMC article.
Reproductive factors and risk of estrogen receptor positive, triple-negative, and HER2-neu overexpressing breast cancer among women 20-44 years of age.
Christopher I Li, Elisabeth F Beaber, +3 authors, Kathleen E Malone.
Breast Cancer Res Treat, 2012 Dec 12; 137(2). PMID: 23224237    Free PMC article.
Impact of premenopausal status at breast cancer diagnosis in women entered on the placebo-controlled NCIC CTG MA17 trial of extended adjuvant letrozole.
P E Goss, J N Ingle, +11 authors, D Tu.
Ann Oncol, 2012 Oct 03; 24(2). PMID: 23028039    Free PMC article.
Targeting RANKL in breast cancer: bone metastasis and beyond.
Hamdy Azim, Hatem A Azim.
Expert Rev Anticancer Ther, 2013 Feb 15; 13(2). PMID: 23406560
Review.
Utility of prognostic genomic tests in breast cancer practice: The IMPAKT 2012 Working Group Consensus Statement.
H A Azim, S Michiels, +9 authors, C Swanton.
Ann Oncol, 2013 Jan 23; 24(3). PMID: 23337633    Free PMC article.
Case control study of women treated with chemotherapy for breast cancer during pregnancy as compared with nonpregnant patients with breast cancer.
Jennifer K Litton, Carla L Warneke, +8 authors, Richard L Theriault.
Oncologist, 2013 Apr 12; 18(4). PMID: 23576478    Free PMC article.
Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.
Christina Davies, Hongchao Pan, +36 authors, Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group.
Lancet, 2012 Dec 12; 381(9869). PMID: 23219286    Free PMC article.
Highly Cited.
Prospective observational study of breast cancer treatment outcomes for UK women aged 18-40 years at diagnosis: the POSH study.
Ellen Copson, Bryony Eccles, +11 authors, POSH Study Steering Group.
J Natl Cancer Inst, 2013 Jun 01; 105(13). PMID: 23723422
Prognosis of women with primary breast cancer diagnosed during pregnancy: results from an international collaborative study.
Frédéric Amant, Gunter von Minckwitz, +20 authors, Sibylle Loibl.
J Clin Oncol, 2013 Apr 24; 31(20). PMID: 23610117
Association between chronological change of reproductive factors and breast cancer risk defined by hormone receptor status: results from the Seoul Breast Cancer Study.
Seokang Chung, Sue K Park, +7 authors, Daehee Kang.
Breast Cancer Res Treat, 2013 Aug 01; 140(3). PMID: 23901017
Breast cancer in Arab populations: molecular characteristics and disease management implications.
Lotfi Chouchane, Hammouda Boussen, Konduru S R Sastry.
Lancet Oncol, 2013 Sep 03; 14(10). PMID: 23993386
Review.
Ten-year survival in patients with BRCA1-negative and BRCA1-positive breast cancer.
Tomasz Huzarski, Tomasz Byrski, +20 authors, Steven A Narod.
J Clin Oncol, 2013 Aug 14; 31(26). PMID: 23940229
Management of breast cancer in very young women.
Rachel A Freedman, Ann H Partridge.
Breast, 2013 Oct 01; 22 Suppl 2. PMID: 24074783
Review.
Prediction of late distant recurrence in patients with oestrogen-receptor-positive breast cancer: a prospective comparison of the breast-cancer index (BCI) assay, 21-gene recurrence score, and IHC4 in the TransATAC study population.
Dennis C Sgroi, Ivana Sestak, +9 authors, Mitch Dowsett.
Lancet Oncol, 2013 Sep 17; 14(11). PMID: 24035531    Free PMC article.
Highly Cited.
Factors predicting late recurrence for estrogen receptor-positive breast cancer.
Ivana Sestak, Mitch Dowsett, +4 authors, Jack Cuzick.
J Natl Cancer Inst, 2013 Sep 14; 105(19). PMID: 24029245    Free PMC article.
Highly Cited.
Pathological features and survival outcomes of very young patients with early breast cancer: how much is "very young"?
Giuseppe Cancello, Patrick Maisonneuve, +9 authors, Marco Colleoni.
Breast, 2013 Oct 05; 22(6). PMID: 24091127
Silencing NOTCH signaling causes growth arrest in both breast cancer stem cells and breast cancer cells.
S Suman, T P Das, C Damodaran.
Br J Cancer, 2013 Oct 17; 109(10). PMID: 24129237    Free PMC article.
The EndoPredict score provides prognostic information on late distant metastases in ER+/HER2- breast cancer patients.
P Dubsky, J C Brase, +18 authors, Austrian Breast and Colorectal Cancer Study Group (ABCSG).
Br J Cancer, 2013 Oct 26; 109(12). PMID: 24157828    Free PMC article.
Highly Cited.
Biology of breast cancer during pregnancy using genomic profiling.
Hatem A Azim, Sylvain Brohée, +12 authors, Christos Sotiriou.
Endocr Relat Cancer, 2014 May 16; 21(4). PMID: 24825746
Parity induces differentiation and reduces Wnt/Notch signaling ratio and proliferation potential of basal stem/progenitor cells isolated from mouse mammary epithelium.
Fabienne Meier-Abt, Emanuela Milani, +7 authors, Mohamed Bentires-Alj.
Breast Cancer Res, 2013 Apr 30; 15(2). PMID: 23621987    Free PMC article.
Very young women (<35 years) with operable breast cancer: features of disease at presentation.
M Colleoni, N Rotmensz, +12 authors, A Goldhirsch.
Ann Oncol, 2002 Mar 12; 13(2). PMID: 11886005
A gene-expression signature as a predictor of survival in breast cancer.
Marc J van de Vijver, Yudong D He, +18 authors, René Bernards.
N Engl J Med, 2002 Dec 20; 347(25). PMID: 12490681
Highly Cited.
Breast cancer incidence before age 55 in relation to parity and age at first and last births: a prospective study of one million Norwegian women.
G Albrektsen, I Heuch, S Tretli, G Kvåle.
Epidemiology, 1994 Nov 01; 5(6). PMID: 7841242
A multigene assay to predict recurrence of tamoxifen-treated, node-negative breast cancer.
Soonmyung Paik, Steven Shak, +12 authors, Norman Wolmark.
N Engl J Med, 2004 Dec 14; 351(27). PMID: 15591335
Highly Cited.
Pregnancy-associated breast cancer and metastasis.
Pepper Schedin.
Nat Rev Cancer, 2006 Mar 25; 6(4). PMID: 16557280
Highly Cited. Review.
Effects of young age at presentation on survival in breast cancer.
Nagi S El Saghir, Muhieddine Seoud, +4 authors, Ali I Shamseddine.
BMC Cancer, 2006 Jul 22; 6. PMID: 16857060    Free PMC article.
Trends in epidemiology and management of breast cancer in developing Arab countries: a literature and registry analysis.
Nagi S El Saghir, Mazen K Khalil, +5 authors, Ali I Shamseddine.
Int J Surg, 2007 Jul 31; 5(4). PMID: 17660128
Review.
Age-specific differences in oncogenic pathway deregulation seen in human breast tumors.
Carey K Anders, Chaitanya R Acharya, +11 authors, Anil Potti.
PLoS One, 2008 Jan 03; 3(1). PMID: 18167534    Free PMC article.
Full-term pregnancy induces a specific genomic signature in the human breast.
Jose Russo, Gabriela A Balogh, Irma H Russo.
Cancer Epidemiol Biomarkers Prev, 2008 Jan 18; 17(1). PMID: 18199711
Recent trends in breast cancer among younger women in the United States.
Louise A Brinton, Mark E Sherman, J Daniel Carreon, William F Anderson.
J Natl Cancer Inst, 2008 Nov 13; 100(22). PMID: 19001605    Free PMC article.
Gene-expression signatures in breast cancer.
Christos Sotiriou, Lajos Pusztai.
N Engl J Med, 2009 Feb 21; 360(8). PMID: 19228622
Highly Cited. Review.
Elevated breast cancer mortality in women younger than age 40 years compared with older women is attributed to poorer survival in early-stage disease.
Jennifer L Gnerlich, Anjali D Deshpande, +3 authors, Julie A Margenthaler.
J Am Coll Surg, 2009 Mar 26; 208(3). PMID: 19317994    Free PMC article.
Highly Cited.
The prevalence of BRCA1 mutations among young women with triple-negative breast cancer.
S R Young, Robert T Pilarski, +11 authors, Steven A Narod.
BMC Cancer, 2009 Mar 21; 9. PMID: 19298662    Free PMC article.
Aberrant luminal progenitors as the candidate target population for basal tumor development in BRCA1 mutation carriers.
Elgene Lim, François Vaillant, +18 authors, Geoffrey J Lindeman.
Nat Med, 2009 Aug 04; 15(8). PMID: 19648928
Highly Cited.
Breast cancer in young women: poor survival despite intensive treatment.
Hanna Fredholm, Sonja Eaker, +3 authors, Henrik Lindman.
PLoS One, 2009 Nov 13; 4(11). PMID: 19907646    Free PMC article.
Highly Cited.
Relationship between age at diagnosis and outcome of premenopausal breast cancer: age less than 35 years is a reasonable cut-off for defining young age-onset breast cancer.
Wonshik Han, So Young Kang, Korean Breast Cancer Society.
Breast Cancer Res Treat, 2009 Apr 08; 119(1). PMID: 19350387
Gene expression patterns in the human breast after pregnancy.
Szilard Asztalos, Peter H Gann, +5 authors, Debra A Tonetti.
Cancer Prev Res (Phila), 2010 Feb 25; 3(3). PMID: 20179293
Alternatively activated macrophages and collagen remodeling characterize the postpartum involuting mammary gland across species.
Jenean O'Brien, Traci Lyons, +6 authors, Pepper Schedin.
Am J Pathol, 2010 Jan 30; 176(3). PMID: 20110414    Free PMC article.
Highly Cited.
Control of mammary stem cell function by steroid hormone signalling.
Marie-Liesse Asselin-Labat, François Vaillant, +8 authors, Jane E Visvader.
Nature, 2010 Apr 13; 465(7299). PMID: 20383121
Highly Cited.
Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (<35 years) with operable breast cancer.
G Cancello, P Maisonneuve, +12 authors, M Colleoni.
Ann Oncol, 2010 Mar 25; 21(10). PMID: 20332136
Higher parity and shorter breastfeeding duration: association with triple-negative phenotype of breast cancer.
Shivani S Shinde, Michele R Forman, +6 authors, W Fraser Symmans.
Cancer, 2010 Jul 29; 116(21). PMID: 20665494
RANK ligand mediates progestin-induced mammary epithelial proliferation and carcinogenesis.
Eva Gonzalez-Suarez, Allison P Jacob, +6 authors, William C Dougall.
Nature, 2010 Oct 01; 468(7320). PMID: 20881963
Highly Cited.
Emerging breast cancer epidemic: evidence from Africa.
Sally N Akarolo-Anthony, Temidayo O Ogundiran, Clement A Adebamowo.
Breast Cancer Res, 2011 Jan 05; 12 Suppl 4. PMID: 21172092    Free PMC article.
Breast carcinomas arising at a young age: unique biology or a surrogate for aggressive intrinsic subtypes?
Carey K Anders, Cheng Fan, +4 authors, Charles M Perou.
J Clin Oncol, 2010 Dec 01; 29(1). PMID: 21115855    Free PMC article.
Inherited mutations in breast cancer genes--risk and response.
Andrew Y Shuen, William D Foulkes.
J Mammary Gland Biol Neoplasia, 2011 Apr 05; 16(1). PMID: 21461995
Review.
Parity and lactation in relation to estrogen receptor negative breast cancer in African American women.
Julie R Palmer, Deborah A Boggs, +3 authors, Lynn Rosenberg.
Cancer Epidemiol Biomarkers Prev, 2011 Aug 19; 20(9). PMID: 21846820    Free PMC article.
Postpartum mammary gland involution drives progression of ductal carcinoma in situ through collagen and COX-2.
Traci R Lyons, Jenean O'Brien, +6 authors, Pepper Schedin.
Nat Med, 2011 Aug 09; 17(9). PMID: 21822285    Free PMC article.
Highly Cited.
Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer.
L C Collins, J D Marotti, +8 authors, A H Partridge.
Breast Cancer Res Treat, 2011 Nov 15; 131(3). PMID: 22080245
Elucidating prognosis and biology of breast cancer arising in young women using gene expression profiling.
Hatem A Azim, Stefan Michiels, +7 authors, Sherene Loi.
Clin Cancer Res, 2012 Jan 21; 18(5). PMID: 22261811
Highly Cited.
The biological features and prognosis of breast cancer diagnosed during pregnancy: a case-control study.
Hatem A Azim, Edoardo Botteri, +12 authors, Fedro A Peccatori.
Acta Oncol, 2011 Dec 17; 51(5). PMID: 22171586
Stumbling blocks on the path to personalized medicine in breast cancer: the case of PARP inhibitors for BRCA1/2-associated cancers.
Judith Balmaña, Susan M Domchek, Andrew Tutt, Judy E Garber.
Cancer Discov, 2012 May 16; 1(1). PMID: 22586318
Review.
Mutational processes molding the genomes of 21 breast cancers.
Serena Nik-Zainal, Ludmil B Alexandrov, +51 authors, Breast Cancer Working Group of the International Cancer Genome Consortium.
Cell, 2012 May 23; 149(5). PMID: 22608084    Free PMC article.
Highly Cited.
The clonal and mutational evolution spectrum of primary triple-negative breast cancers.
Sohrab P Shah, Andrew Roth, +56 authors, Samuel Aparicio.
Nature, 2012 Apr 13; 486(7403). PMID: 22495314    Free PMC article.
Highly Cited.
The landscape of cancer genes and mutational processes in breast cancer.
Philip J Stephens, Patrick S Tarpey, +60 authors, Michael R Stratton.
Nature, 2012 Jun 23; 486(7403). PMID: 22722201    Free PMC article.
Highly Cited.
Tumour biomarker expression relative to age and molecular subtypes of invasive breast cancer.
D H Morrison, D Rahardja, +2 authors, V R Sarode.
Br J Cancer, 2012 Jun 21; 107(2). PMID: 22713661    Free PMC article.
Breast feeding, parity and breast cancer subtypes in a Spanish cohort.
Carmen M Redondo, Manuela Gago-Domínguez, +11 authors, J Esteban Castelao.
PLoS One, 2012 Jul 14; 7(7). PMID: 22792365    Free PMC article.
Adherence to adjuvant hormonal therapy among breast cancer survivors in clinical practice: a systematic review.
Caitlin C Murphy, L Kay Bartholomew, +2 authors, Sally W Vernon.
Breast Cancer Res Treat, 2012 Jun 13; 134(2). PMID: 22689091    Free PMC article.
Highly Cited. Systematic Review.
Occurrence of breast cancer subtypes in adolescent and young adult women.
Theresa H M Keegan, Mindy C DeRouen, +2 authors, Christina A Clarke.
Breast Cancer Res, 2012 Mar 29; 14(2). PMID: 22452927    Free PMC article.
RANK-ligand (RANKL) expression in young breast cancer patients and during pregnancy.
Hatem A Azim, Fedro A Peccatori, +7 authors, Christos Sotiriou.
Breast Cancer Res, 2015 Apr 08; 17. PMID: 25849336    Free PMC article.
Genomic aberrations in young and elderly  breast cancer patients.
Hatem A Azim, Bastien Nguyen, +2 authors, Christos Sotiriou.
BMC Med, 2015 Oct 16; 13. PMID: 26467651    Free PMC article.
Association Between Younger Age and Targetable Genomic Alterations and Prognosis in Non-Small-Cell Lung Cancer.
Adrian G Sacher, Suzanne E Dahlberg, +3 authors, Geoffrey R Oxnard.
JAMA Oncol, 2016 Jan 01; 2(3). PMID: 26720421    Free PMC article.
Highly Cited.
Biologic and clinical characteristics of adolescent and young adult cancers: Acute lymphoblastic leukemia, colorectal cancer, breast cancer, melanoma, and sarcoma.
James V Tricoli, Donald G Blair, +10 authors, Cheryl L Willman.
Cancer, 2016 Feb 06; 122(7). PMID: 26849082    Free PMC article.
Review.
Utility of Red Cell Distribution Width as a Prognostic Factor in Young Breast Cancer Patients.
Du-Ping Huang, Rui-Min Ma, You-Qun Xiang.
Medicine (Baltimore), 2016 Apr 29; 95(17). PMID: 27124030    Free PMC article.
A Set of miRNAs, Their Gene and Protein Targets and Stromal Genes Distinguish Early from Late Onset ER Positive Breast Cancer.
E P Bastos, H Brentani, +10 authors, M M Brentani.
PLoS One, 2016 May 07; 11(5). PMID: 27152840    Free PMC article.
Young adult breast cancer patients have a poor prognosis independent of prognostic clinicopathological factors: a study from the Japanese Breast Cancer Registry.
Akemi Kataoka, Takayuki Iwamoto, +16 authors, Yutaka Tokuda.
Breast Cancer Res Treat, 2016 Sep 21; 160(1). PMID: 27647460    Free PMC article.
Suspicious breast calcifications undergoing stereotactic biopsy in women ages 70 and over: Breast cancer incidence by BI-RADS descriptors.
Lars J Grimm, David Y Johnson, +4 authors, Sujata V Ghate.
Eur Radiol, 2016 Oct 19; 27(6). PMID: 27752832
Outcome of Breast Cancer in Moroccan Young Women Correlated to Clinic-Pathological Features, Risk Factors and Treatment: A Comparative Study of 716 Cases in a Single Institution.
Meriem Slaoui, Fatima Zahra Mouh, +3 authors, Mariam Amrani.
PLoS One, 2016 Oct 21; 11(10). PMID: 27760178    Free PMC article.
The prognostic performance of Adjuvant! Online and Nottingham Prognostic Index in young breast cancer patients.
Matteo Lambertini, Ana Catarina Pinto, +12 authors, Hatem A Azim.
Br J Cancer, 2016 Nov 02; 115(12). PMID: 27802449    Free PMC article.
DNA Methylation in Breast Tumor from High-risk Women in the Breast Cancer Family Registry.
Hui-Chen Wu, Melissa C Southey, +2 authors, Mary Beth Terry.
Anticancer Res, 2017 Feb 10; 37(2). PMID: 28179314    Free PMC article.
Ovarian Function Suppression in Premenopausal Women with Early-Stage Breast Cancer.
Matteo Lambertini, Lucia Del Mastro, +3 authors, Evandro de Azambuja.
Curr Treat Options Oncol, 2017 Feb 12; 18(1). PMID: 28185173
Review.
Breast cancer in young women: an overview.
Zoi Anastasiadi, Georgios D Lianos, +2 authors, Michail Mitsis.
Updates Surg, 2017 Mar 06; 69(3). PMID: 28260181
Highly Cited. Review.
Initiation of Trastuzumab by Women Younger Than 64 Years for Adjuvant Treatment of Stage I-III Breast Cancer.
Huei-Ting Tsai, Claudine Isaacs, +6 authors, Arnold L Potosky.
J Natl Compr Canc Netw, 2017 May 10; 15(5). PMID: 28476740    Free PMC article.
Nipple aspirate fluid-A liquid biopsy for diagnosing breast health.
Sadr-Ul Shaheed, Catherine Tait, +6 authors, Chris W Sutton.
Proteomics Clin Appl, 2017 May 11; 11(9-10). PMID: 28488344    Free PMC article.
Prognostic value of ABO blood types in young patients with breast cancer; a nationwide study in Korean Breast Cancer Society.
Sungmin Park, Ku Sang Kim, +10 authors, Korean Breast Cancer Society.
Med Oncol, 2017 May 14; 34(6). PMID: 28500618
The PREgnancy and FERtility (PREFER) study: an Italian multicenter prospective cohort study on fertility preservation and pregnancy issues in young breast cancer patients.
Matteo Lambertini, Paola Anserini, +13 authors, Lucia Del Mastro.
BMC Cancer, 2017 May 21; 17(1). PMID: 28526012    Free PMC article.
Treatment Efficacy, Adherence, and Quality of Life Among Women Younger Than 35 Years in the International Breast Cancer Study Group TEXT and SOFT Adjuvant Endocrine Therapy Trials.
Poornima Saha, Meredith M Regan, +25 authors, International Breast Cancer Study Group.
J Clin Oncol, 2017 Jun 28; 35(27). PMID: 28654365    Free PMC article.
Lung adenocarcinoma patients of young age have lower EGFR mutation rate and poorer efficacy of EGFR tyrosine kinase inhibitors.
Shang-Gin Wu, Yih-Leong Chang, +2 authors, Jin-Yuan Shih.
ERJ Open Res, 2017 Jul 19; 3(3). PMID: 28717642    Free PMC article.
Involvement of hedgehog pathway in early onset, aggressive molecular subtypes and metastatic potential of breast cancer.
Syeda Kiran Riaz, Jahangir Sarwar Khan, +4 authors, Muhammad Faraz Arshad Malik.
Cell Commun Signal, 2018 Jan 14; 16(1). PMID: 29329585    Free PMC article.
Differences in breast cancer incidence among young women aged 20-49 years by stage and tumor characteristics, age, race, and ethnicity, 2004-2013.
Meredith L Shoemaker, Mary C White, +2 authors, Isabelle Romieu.
Breast Cancer Res Treat, 2018 Feb 16; 169(3). PMID: 29445940    Free PMC article.
CHEK2 Germ Line Mutations are Lacking among Familial and Sporadic Breast Cancer Patients in Rwanda
Thierry Habyarimana, Mohammed Attaleb, +3 authors, Mohammed El Mzibri.
Asian Pac J Cancer Prev, 2018 Feb 27; 19(2). PMID: 29479983    Free PMC article.
Biology, staging, and treatment of breast cancer during pregnancy: reassessing the evidences.
Fedro Alessandro Peccatori, Matteo Lambertini, +2 authors, Giovanni Codacci-Pisanelli.
Cancer Biol Med, 2018 Mar 17; 15(1). PMID: 29545964    Free PMC article.
Characteristics of genomic alterations of lung adenocarcinoma in young never-smokers.
Wenxin Luo, Panwen Tian, +15 authors, Weimin Li.
Int J Cancer, 2018 Apr 19; 143(7). PMID: 29667179    Free PMC article.
Clinicopathologic Factors Related to the Histological Tumor Grade of Breast Cancer in Western China: An Epidemiological Multicenter Study of 8619 Female Patients.
Ke Zheng, Jin-Xiang Tan, +21 authors, Guo-Sheng Ren.
Transl Oncol, 2018 Jul 10; 11(4). PMID: 29982100    Free PMC article.
Clinical relevance of the 21-gene Recurrence Score® assay in treatment decisions for patients with node-positive breast cancer in the genomic era.
Eleftherios P Mamounas, Christy A Russell, +2 authors, Kathy S Albain.
NPJ Breast Cancer, 2018 Aug 30; 4. PMID: 30155517    Free PMC article.
Review.
Changing patterns and survival improvements of young breast cancer in China and SEER database, 1999-2017.
Rong Guo, Jing Si, +7 authors, Jiong Wu.
Chin J Cancer Res, 2019 Oct 01; 31(4). PMID: 31564808    Free PMC article.
Advanced Stage at Diagnosis and Worse Clinicopathologic Features in Young Women with Breast Cancer in Brazil: A Subanalysis of the AMAZONA III Study (GBECAM 0115).
Maria Alice Franzoi, Daniela D Rosa, +26 authors, Pedro E R Liedke.
J Glob Oncol, 2019 Nov 16; 5. PMID: 31730380    Free PMC article.
Breast Cancer in Young Women: Status Quo and Advanced Disease Management by a Predictive, Preventive, and Personalized Approach.
Erik Kudela, Marek Samec, +11 authors, Daniela Trog.
Cancers (Basel), 2019 Nov 20; 11(11). PMID: 31739537    Free PMC article.
Review.
Adjuvant Anti-HER2 Therapy, Treatment-Related Amenorrhea, and Survival in Premenopausal HER2-Positive Early Breast Cancer Patients.
Matteo Lambertini, Christine Campbell, +19 authors, Evandro de Azambuja.
J Natl Cancer Inst, 2018 Jun 08; 111(1). PMID: 29878225    Free PMC article.
Incidence and Survival Among Young Women With Stage I-III Breast Cancer: SEER 2000-2015.
Alexandra Thomas, Anthony Rhoads, +7 authors, Paul A Romitti.
JNCI Cancer Spectr, 2019 Aug 09; 3(3). PMID: 31392297    Free PMC article.
Where youth matters-clinicopathologic characteristics and emerging trends in treatment and outcomes in young Irish women with breast cancer.
Megan Greally, Jennifer Kielty, +11 authors, Janice M Walshe.
Ir J Med Sci, 2018 May 17; 188(1). PMID: 29766409
Pathological profiles and clinical management challenges of breast cancer emerging in young women in Indonesia: a hospital-based study.
Sumadi Lukman Anwar, Clarista Adelia Raharjo, +8 authors, Wahyu Wulaningsih.
BMC Womens Health, 2019 Feb 08; 19(1). PMID: 30728000    Free PMC article.
MicroRNA-196a is regulated by ER and is a prognostic biomarker in ER+ breast cancer.
Michael J G Milevskiy, Udai Gujral, +7 authors, Melissa A Brown.
Br J Cancer, 2019 Feb 21; 120(6). PMID: 30783203    Free PMC article.
Clinicopathological Features of Young Versus Older Patients With Breast Cancer at a Single Pakistani Institution and a Comparison With a National US Database.
Sana Zeeshan, Basim Ali, +2 authors, Abida K Sattar.
J Glob Oncol, 2019 Mar 13; 5. PMID: 30860954    Free PMC article.
Role of Hedgehog Signaling in Breast Cancer: Pathogenesis and Therapeutics.
Natalia A Riobo-Del Galdo, Ángela Lara Montero, Eva V Wertheimer.
Cells, 2019 Apr 28; 8(4). PMID: 31027259    Free PMC article.
Review.
Machine learning techniques for personalized breast cancer risk prediction: comparison with the BCRAT and BOADICEA models.
Chang Ming, Valeria Viassolo, +3 authors, Maria C Katapodi.
Breast Cancer Res, 2019 Jun 22; 21(1). PMID: 31221197    Free PMC article.
Breast cancer tumor histopathology, stage at presentation, and treatment in the extremes of age.
Jennifer K Plichta, Samantha M Thomas, +5 authors, Rachel A Greenup.
Breast Cancer Res Treat, 2020 Jan 26; 180(1). PMID: 31980967    Free PMC article.
Optimal radiotherapy for patients with internal mammary lymph node metastasis from breast cancer.
Kyungmi Yang, Haeyoung Kim, +3 authors, Won Kyung Cho.
Radiat Oncol, 2020 Mar 04; 15(1). PMID: 32122399    Free PMC article.
Clinical Decision Support Systems in Breast Cancer: A Systematic Review.
Claudia Mazo, Cathriona Kearns, Catherine Mooney, William M Gallagher.
Cancers (Basel), 2020 Feb 12; 12(2). PMID: 32041094    Free PMC article.
Review.
Tumor Mutational Patterns and Infiltrating Lymphocyte Density in Young and Elderly Patients With Breast Cancer.
Adamantia Nikolaidi, Vassiliki Kotoula, +17 authors, George Fountzilas.
Cancer Genomics Proteomics, 2020 Feb 29; 17(2). PMID: 32108041    Free PMC article.
Prognosis in young women less than 40 years of age with brain metastasis from breast cancer.
A Mustillo, J P Ayoub, +2 authors, M Florescu.
Curr Oncol, 2020 Mar 29; 27(1). PMID: 32218659    Free PMC article.
Incorporation of clinical and biological factors improves prognostication and reflects contemporary clinical practice.
Rashmi K Murthy, Juhee Song, +8 authors, Gabriel N Hortobagyi.
NPJ Breast Cancer, 2020 Mar 29; 6. PMID: 32219153    Free PMC article.
Review.
Rapid Microwave-Assisted Cisplatin-Loaded Solid Lipid Nanoparticles: Synthesis, Characterization and Anticancer Study.
Hibah M Aldawsari, Sima Singh.
Nanomaterials (Basel), 2020 Mar 15; 10(3). PMID: 32168934    Free PMC article.
The Importance of Education regarding the Effects of Anticancer Treatment on Fertility and Ovarian Function in the Female Patients with Breast Cancer.
Sunah Shin, Juhee Kim, +10 authors, Hee Jeong Kim.
J Menopausal Med, 2020 Apr 21; 25(3). PMID: 32307939    Free PMC article.
Reproductive Risk Factors Associated with Breast Cancer Molecular Subtypes among Young Women in Northern China.
Jian Ming Wang, Jun Wang, +2 authors, Fei Yang Wang.
Biomed Res Int, 2020 Apr 28; 2020. PMID: 32337260    Free PMC article.
Female medical students' awareness, attitudes, and knowledge about early detection of breast cancer in Syrian Private University, Syria.
Abdullah Omar, Aliaa Bakr, Nazir Ibrahim.
Heliyon, 2020 May 06; 6(4). PMID: 32368654    Free PMC article.
Differences in Breast Cancer Stage at Diagnosis by Ethnicity, Insurance Status, and Family Income in Young Women in the USA.
Maria Alice Franzoi, Gilberto Schwartsmann, +3 authors, Pedro E R Liedke.
J Racial Ethn Health Disparities, 2019 May 19; 6(5). PMID: 31102102
Validation of the 8th edition of the American Joint Committee on Cancer Pathological Prognostic Staging for young breast cancer patients.
Juan Zhou, Jian Lei, +4 authors, San-Gang Wu.
Aging (Albany NY), 2020 Apr 23; 12(8). PMID: 32320950    Free PMC article.
TP53 rs1042522 polymorphism and early-onset breast cancer.
Irmak Icen-Taskin, Sevgi Irtegun-Kandemir, Omer Munzuroglu.
J Res Med Sci, 2020 May 19; 25. PMID: 32419782    Free PMC article.
Immunohistochemical expression of interleukin-17 and hormonal receptors in benign and malignant breast lesions.
Eman Taha Ali, Mai Abdulrahman Mohammed Masri, +4 authors, Ali Mahmoud Mohammed Edris.
BMC Res Notes, 2020 Jun 25; 13(1). PMID: 32576277    Free PMC article.
Current State of the Art in the Adjuvant Systemic Treatment of Premenopausal Patients With Early Breast Cancer.
Francesca Parisi, Maria Grazia Razeti, +7 authors, Matteo Lambertini.
Clin Med Insights Oncol, 2020 Jul 11; 14. PMID: 32647477    Free PMC article.
Clinico-pathologic features, treatment and outcomes of breast cancer during pregnancy or the post-partum period.
Ciara C O'Sullivan, Sheeba Irshad, +6 authors, Karen Lisa Smith.
Breast Cancer Res Treat, 2020 Mar 13; 180(3). PMID: 32162192    Free PMC article.
Incidence and Survival by Human Epidermal Growth Factor Receptor 2 Status in Young Women With Stage I-III Breast Cancer: SEER, 2010-2016.
Alexandra Thomas, Anthony Rhoads, +7 authors, Paul A Romitti.
Clin Breast Cancer, 2020 Apr 13; 20(4). PMID: 32278642    Free PMC article.
High Levels of Chromosomal Copy Number Alterations and TP53 Mutations Correlate with Poor Outcome in Younger Breast Cancer Patients.
Ayla Koçak, Kerstin Heselmeyer-Haddad, +13 authors, Thomas Ried.
Am J Pathol, 2020 May 18; 190(8). PMID: 32416097    Free PMC article.
Machine learning-based lifetime breast cancer risk reclassification compared with the BOADICEA model: impact on screening recommendations.
Chang Ming, Valeria Viassolo, +3 authors, Maria C Katapodi.
Br J Cancer, 2020 Jun 23; 123(5). PMID: 32565540    Free PMC article.
Update on fertility preservation for younger women with breast cancer.
Ellen Warner, Karen Glass, Shu Foong, Emily Sandwith.
CMAJ, 2020 Sep 02; 192(35). PMID: 32868272    Free PMC article.
Review.
Burning Questions in the Oncofertility Counseling of Young Breast Cancer Patients.
Luca Arecco, Marta Perachino, +10 authors, Matteo Lambertini.
Breast Cancer (Auckl), 2020 Sep 22; 14. PMID: 32952399    Free PMC article.
Review.
Locally advanced breast cancer in young women in Latin America.
Cynthia Villarreal-Garza, Edna A Lopez-Martinez, Jose Felipe Muñoz-Lozano, Karla Unger-Saldaña.
Ecancermedicalscience, 2019 Feb 23; 13. PMID: 30792811    Free PMC article.
Review.
Genomic alterations and survival in young patients aged under 40 years with completely resected non-small cell lung cancer.
Shifeng Yang, Zhengbo Song, Guoping Cheng.
Ann Transl Med, 2019 Jun 04; 7(7). PMID: 31157261    Free PMC article.
Endocrine and Targeted Therapy for Hormone-Receptor-Positive, HER2-Negative Advanced Breast Cancer: Insights to Sequencing Treatment and Overcoming Resistance Based on Clinical Trials.
Rola El Sayed, Lara El Jamal, +3 authors, Hazem Assi.
Front Oncol, 2019 Jul 10; 9. PMID: 31281796    Free PMC article.
Review.
Impact of Taxanes, Endocrine Therapy, and Deleterious Germline BRCA Mutations on Anti-müllerian Hormone Levels in Early Breast Cancer Patients Treated With Anthracycline- and Cyclophosphamide-Based Chemotherapy.
Matteo Lambertini, Nathalie Olympios, +8 authors, Florian Clatot.
Front Oncol, 2019 Jul 30; 9. PMID: 31355134    Free PMC article.
Clinical utility of genomic signatures in young breast cancer patients: a systematic review.
Cynthia Villarreal-Garza, Ana S Ferrigno, +3 authors, Hatem A Azim.
NPJ Breast Cancer, 2020 Oct 17; 6. PMID: 33062888    Free PMC article.
Review.
Breast-conserving surgery with or without irradiation in women with invasive ductal carcinoma of the breast receiving preoperative systemic therapy: A cohort study.
Jiaqiang Zhang, Chang-Yun Lu, +2 authors, Szu-Yuan Wu.
Breast, 2020 Oct 14; 54. PMID: 33049657    Free PMC article.
Incidence of hypothyroidism after treatment for breast cancer-a Danish matched cohort study.
Anne Mette Falstie-Jensen, Buket Ö Esen, +6 authors, Deirdre P Cronin-Fenton.
Breast Cancer Res, 2020 Oct 15; 22(1). PMID: 33050919    Free PMC article.
Downregulated METTL14 Expression Correlates with Breast Cancer Tumor Grade and Molecular Classification.
Xiao-Fang Dong, Yan Wang, +5 authors, Chao-Qun Wang.
Biomed Res Int, 2020 Nov 03; 2020. PMID: 33134390    Free PMC article.
Tumorigenesis-related key genes in adolescents and young adults with HR(+)/HER2(-) breast cancer.
Shun Yi, Wei Zhou.
Int J Clin Exp Pathol, 2020 Nov 10; 13(10). PMID: 33165441    Free PMC article.
Tamoxifen exposure in pregnancy after synchronous breast and thyroid cancer.
Abeid M Athman Omar, Amany Abdel-Bary, Rasha O Elsaka.
Ecancermedicalscience, 2020 Nov 20; 14. PMID: 33209116    Free PMC article.
The Tumor-Fat Interface Volume of Breast Cancer on Pretreatment MRI Is Associated with a Pathologic Response to Neoadjuvant Chemotherapy.
Hwan-Ho Cho, Minsu Park, +5 authors, Sung Hoon Sim.
Biology (Basel), 2020 Nov 14; 9(11). PMID: 33182628    Free PMC article.
Management of young women with early breast cancer.
Francesca Poggio, Matteo Lambertini, +6 authors, Lucia Del Mastro.
ESMO Open, 2018 Dec 19; 3(Suppl 1). PMID: 30559981    Free PMC article.
Association of serum adiponectin with breast cancer: A meta-analysis of 27 case-control studies.
Zeping Yu, Shenli Tang, +2 authors, Yong Zeng.
Medicine (Baltimore), 2019 Feb 09; 98(6). PMID: 30732167    Free PMC article.
Breast cancer care in northern Ethiopia - cross-sectional analysis.
Biniyam Tefera Deressa, Nikola Cihoric, +2 authors, Daniel Rauch.
BMC Cancer, 2019 Apr 27; 19(1). PMID: 31023270    Free PMC article.
Hormonal Receptors, Human Epidermal Growth Factor Receptor-2 and Triple Negative Immunohistochemical Typing in Women with Breast Cancer in Kampala, Uganda.
Angela T Mlole, James J Yahaya, +2 authors, Andrew L Okwi.
Int J Womens Health, 2020 Dec 22; 12. PMID: 33343201    Free PMC article.
Role of GATA3 exon 6 germline mutations in breast cancer progression in Egyptian female patients.
Iman H Ibrahim, Heba G Abdel-Aziz, Fatema Em Hassan, Hesham Sa El-Sameea.
Exp Biol Med (Maywood), 2020 Sep 18; 246(1). PMID: 32938228    Free PMC article.
Breast cancer in very young women-a multicenter 10-year experience.
I F Eiriz, M Vaz Batista, +3 authors, S Braga.
ESMO Open, 2021 Jan 06; 6(1). PMID: 33399090    Free PMC article.
Clinical features, prognosis, and influencing factors of contralateral prophylactic mastectomy in 58 patients with breast cancer.
Yiqiong Zheng, Jie Li, +8 authors, Yanjun Zhang.
Ann Transl Med, 2021 Jan 26; 8(24). PMID: 33490177    Free PMC article.
The Effects of Negative Elements in Environment and Cancer on Female Reproductive System.
Jiangxue Qu, Yuehan Li, Shujie Liao, Jie Yan.
Adv Exp Med Biol, 2021 Feb 02; 1300. PMID: 33523439
CDKN1B mutation and copy number variation are associated with tumor aggressiveness in luminal breast cancer.
Davide Viotto, Francesca Russo, +32 authors, Gustavo Baldassarre.
J Pathol, 2020 Nov 04; 253(2). PMID: 33140857    Free PMC article.

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Effects of clinicopathological factors on prognosis of young patients with resected breast cancer.
Wen Li, Yunfu Deng, +8 authors, Qinghua Zhou.
Medicine (Baltimore), 2021 Feb 18; 100(5). PMID: 33592828    Free PMC article.
Clinical behavior and outcomes of breast cancer in young women with germline BRCA pathogenic variants.
Matteo Lambertini, Marcello Ceppi, +36 authors, Hatem A Azim.
NPJ Breast Cancer, 2021 Feb 14; 7(1). PMID: 33579978    Free PMC article.
Clinicopathological Characteristics and Prognosis of Breast Cancer in Young Women - A Single Center Study in a Developing Country.
Xiaoliang Sun, Jun Liu, +2 authors, Yao Lu.
Cancer Manag Res, 2021 Feb 26; 13. PMID: 33628050    Free PMC article.
Understanding the function of the tumor microenvironment, and compounds from marine organisms for breast cancer therapy.
Rama Rao Malla, Batoul Farran, Ganji Purnachandra Nagaraju.
World J Biol Chem, 2021 Apr 06; 12(2). PMID: 33815682    Free PMC article.
Review.
Time to Pregnancy, Obstetrical and Neonatal Outcomes after Breast Cancer: A Study from the Maternity Network for Young Breast Cancer Patients.
Julie Labrosse, Anne Lecourt, +13 authors, Anne-Sophie Hamy.
Cancers (Basel), 2021 Apr 04; 13(5). PMID: 33802333    Free PMC article.