News on the medical treatment of young women with early-stage HER2-negative breast cancer.
BACKGROUND
Breast cancer in young women represents a public health problem with specific age-related issues to be faced by both patients and their treating physicians.


METHODS
This manuscript reviews the recent data on the medical management of young women with early-stage HER2-negative breast cancer.


CONCLUSIONS
For women candidates to receive (neo)adjuvant chemotherapy, anthracycline- and taxane-based regimens are standard of care. In high-risk patients, dose-dense regimens should be preferred; in women with triple-negative breast cancer and BRCA mutations, the addition of platinum compounds may also be considered. Several adjuvant endocrine therapy options have become available for the treatment of premenopausal women with early-stage luminal breast cancer. Specifically, young patients at low risk of relapse may be safely spared chemotherapy: endocrine therapy alone with tamoxifen for 5 years is the most appropriate treatment. In women at higher risk of relapse, ovarian function suppression is therapeutic: in this scenario, luteinizing hormone-releasing hormone agonists (LHRHa) should be considered in addition to tamoxifen or aromatase inhibitors. To women concerned about the possible risk of chemotherapy-induced premature ovarian failure, the use of temporary ovarian suppression with LHRHa should be proposed as a valid strategy to potentially preserve ovarian function and fertility.
a Department of Medical Oncology , U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST , Genova , Italy.|b BrEAST Data Centre, Department of Medicine , Institut Jules Bordet, and l'Université Libre de Bruxelles (U.L.B.) , Brussels , Belgium.
Matteo
M
Lambertini
a Department of Medical Oncology , U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST , Genova , Italy.
Francesca
F
Poggio
c Department of Medical Oncology , U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino, IST , Genova , Italy.
Marina
M
Vaglica
a Department of Medical Oncology , U.O. Oncologia Medica 2, IRCCS AOU San Martino, IST , Genova , Italy.
Eva
E
Blondeaux
c Department of Medical Oncology , U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino, IST , Genova , Italy.
Lucia
L
Del Mastro
D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D001952:Bridged-Ring Compounds / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D009364:Neoplasm Recurrence, Local; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism; D013629:Tamoxifen / Q000627:therapeutic use; D043823:Taxoids / Q000627:therapeutic use
D018943:Anthracyclines; D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors; D001952:Bridged-Ring Compounds; D007987:Gonadotropin-Releasing Hormone; D018719:Erb-b2 Receptor Tyrosine Kinases; D013629:Tamoxifen; D043823:Taxoids; C080625:taxane; C508053:ERBB2 protein, human
(neo)adjuvant therapy; Breast cancer; chemotherapy; endocrine therapy; ovarian function preservation; young women