Advanced breast cancer in young women

Metastatic breast cancer (MBC) is cancer that has spread to other parts of the body than the breast, such as the bones, liver, lung or brain. This is categorised as an advanced stage of cancer. Metastatic breast cancer can also be called Stage IV or advanced cancer.

For young women diagnosed with MBC it is important to know that while it is not curable, it is highly treatable. In fact, younger women with de novo MBC (stage IV disease upon diagnosis) were found to have better outcomes compared to their older counterparts.

Treatment is lifelong and focuses on preventing further spread of the cancer while managing symptoms. The intention of treating is to help the patient have a good quality of life for as long as possible. This is especially important for young women who must deal with accepting a very different future to the one they envisaged prior to diagnosis.

With the development of numerous new cancer treatments in recent years, many more options have become available for women with MBC.  The most common types of breast cancer in young women are HER2 and TNBC. While they represent the more aggressive types of breast cancer, there are also exciting trials underway with newer and more effective drugs in the pipeline.

• Phase II trial DESTINY-Breast01, implemented Enhertu monotherapy in patients with HER2-positive metastatic breast cancer. The trial has shown strong results, with the majority of women benefiting from treatment and the median duration of the response exceeding 14 months. For more on this trial click here.
• Phase III trial IMPASSION 130, assigned patients with untreated metastatic triple-negative breast cancer to receive atezolizumab plus nab-paclitaxe and showed that in select patients, their overall survival was increased by as much as 10 months. For more on this trial click here.

A holistic approach to MBC must combine treatment and palliative care to help young women navigate the long-term nature of this disease.

Palliative care should be part of a young woman’s MBC plan from the beginning. Palliative care encompasses the treatment of side effects, stress and pain. Palliative care should not be confused with hospice care, which supports patients at the end-stage of their cancer.