Onkologie. 2023:17(3):150-156 | DOI: 10.36290/xon.2023.030

Treatment issues of HER2 positive breast cancer in adult young patients

Miloš Holánek

Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno

HER2-positive cancer is an aggressive subtype of breast tumors and requires complex oncological treatment. In patients with early-stage disease, the goal is to achieve long-term remission of the disease, while in patients with metastatic disease, the goal of treatment is to achieve long-term disease control, prolong overall survival and influence disease symptoms to improve quality of life. The treatment of adult young breast cancer patients is specific in many ways. This subset of patients is more likely to be diagnosed with aggressive subtypes, more advanced diseases, and higher-grade tumors with lower steroid receptor expression. Hereditary carcinomas are more represented, the issue of fertility preservation is discussed, and the treatment of pregnant and lactating patients is a separate chapter. In the context of surgical procedures, the issue of reconstructive procedures is addressed. As far as systemic treatment is concerned, adult young patients are more often treated with neoadjuvant therapy due to the different representation of individual subtypes of breast cancer and more advanced stages of the disease; more often we choose intensification of treatment, e. g. in the form of dose-dense regimens. In the context of adjuvant hormonal therapy, hormone therapy combined with ovarian suppression is chosen in young patients when indicated. The treatment of young patients with HER2-positive disease is in most cases based on the same guidelines as for other breast cancer patients. However, some specificities in clinical practice will be discussed in the context of this article. The indication of the different diagnostic and therapeutic procedures within a multidisciplinary team is essential, as this is the only way to achieve the best results.

Keywords: breast cancer, HER2 receptor, anti-HER2 therapy, adult young patients, neoadjuvant therapy, adjuvant therapy, metastatic disease, trastuzumab.

Accepted: June 12, 2023; Published: June 16, 2023  Show citation