Treatment of Breast Cancer in Adolescents and Young Adults (AYA)

Breast cancer is the most frequently diagnosed cancer among AYA women aged 15 to 39 years, accounting for about 14% of all AYA cancer diagnoses.[16] Breast cancer in this age group has a more aggressive course and worse outcome than in older women. Expression of hormone receptors for estrogen, progesterone, and human epidermal growth factor receptor 2 (HER2) on breast cancer in the AYA group is also different from that in older women and correlates with a worse prognosis.[8,17]

In a review of data from the National Cancer Database, AYA patients (aged 15–39 years) had a higher incidence of triple-negative breast cancer (TNBC) or HER2-positive (HER2+) cancer than did adult patients (TNBC: 21.2% vs. 13.8%, respectively; HER2+: 26.0% vs. 18.6%, respectively; both P < .001). In addition, patients aged 15 to 29 years had more advanced disease and TNBC or HER2+ disease than did patients aged 30 to 39 years.[18][Level of evidence C1]

Treatment of AYA patients is similar to that of older women. However, unique aspects of management include attention to genetic implications (i.e., familial breast cancer syndromes) and fertility.[19,20]

For more information, see Breast Cancer Treatment and Genetics of Breast and Gynecologic Cancers.