Challenges in Management of Breast Cancer in Young Women

Breast cancer in young women (YBC) is usually preceded by symptoms and seldom on screening in high-risk women. Diagnosis is delayed and difficult due to a low index of suspicion, no regular screening, dubious or unclear family history, difficulty in imaging, and confusion with benign conditions at a young age, especially when detected during pregnancy or lactation. Treatment for YBC usually follows standard guidelines for breast cancer but some special consideration may be needed depending on patient choices or disease characteristics, concerns about late toxicity including second malignancies, and effects on fertility and ovarian function. Rehabilitation is an important aspect that needs to address sexual health, workplace and societal adjustments, social acceptance and stigma, counseling of caregivers, and psychosocial support to address body image and issues stemming from adverse prognosis. Appropriate discussion regarding contraception during therapy, future pregnancy planning, genetic testing, and counseling is crucial.