Editor's Note: The "2024 Yixian Breast Cancer Conference and the Second China Young Breast Cancer Consensus Conference" took place in Guangzhou from December 27 to 28, 2024. The conference explored cutting-edge topics such as the evolving epidemiology of young breast cancer, screening strategies, the impact of genetic mutations, treatment, and recovery approaches. Highlights included the release of the YBCC Consensus on Diagnosis and Treatment (Patient Edition), the China Genetic Mutation Pathogenicity Database, and the Young Breast Cancer Quality of Life Scale. Oncology Frontier interviewed Dr. Qiang Liu, the conference chair from Sun Yat-sen Memorial Hospital, Sun Yat-sen University, to discuss key highlights, the unique epidemiological characteristics of young breast cancer, and future plans for advancing standardized care in this area.1. Oncology Frontier: As the conference chair, could you introduce the agenda and share the key highlights of this event?
Dr. Qiang Liu: The full title of this conference is the “2024 Yixian Breast Cancer Conference, The Second China Young Breast Cancer Consensus Conference, and The Third Yixian Breast Cancer Nursing Forum.” It marks three years since the inaugural “China Young Breast Cancer Summit Forum and Consensus Conference/2021 Yixian Breast Cancer Forum.” Over this period, significant progress has been made in the diagnosis and treatment of young breast cancer, and public awareness has improved substantially.
The conference agenda features several highlights. First, we deeply explored the epidemiology of young breast cancer, noting that its incidence is rising faster globally than that of older breast cancer, necessitating increased awareness among young women. Second, we examined screening strategies tailored to young Chinese women, highlighting differences in breast density and genetic mutations compared to Western populations, including discussions on the implications of BRCA1/2 mutations on surgical decisions.
Another major focus was ovarian suppression, ovarian protection, and fertility preservation for young breast cancer patients, emphasizing the importance of holistic recovery. We launched the first China Genetic Mutation Pathogenicity Database and the Young Breast Cancer Quality of Life Scale, which serve as practical tools for both doctors and patients. Additionally, we released a patient-friendly version of the China Young Breast Cancer Diagnosis and Treatment Consensus (YBCC), written in accessible language to help patients better understand their treatment options and achieve full recovery.
The conference comprehensively addressed the latest advancements in epidemiology, screening, genetic mutations, treatment, and recovery, providing critical support and guidance for both medical professionals and patients.
2. Oncology Frontier: What are the unique epidemiological characteristics of young breast cancer?
Dr. Qiang Liu: During the inaugural 2021 Yixian Breast Cancer Forum, I gave a lecture on the epidemiology of young breast cancer. Three years later, I revisited the topic, updating my presentation with the latest data. While preparing, I reviewed substantial new evidence and noted that the rising incidence of young breast cancer is not unique to China. A 2024 study published in CA: A Cancer Journal for Clinicians revealed a global increase in breast cancer incidence.
Young breast cancer has several unique epidemiological characteristics. The incidence of young breast cancer is increasing worldwide, including in China, and its growth rate is significantly faster than that of older breast cancer. For example, in the United States, the growth rate for young breast cancer is twice that of older cases. There are also significant regional variations; Africa has the lowest incidence rates, while the difference in incidence between countries with the highest and lowest rates for young breast cancer is nearly twentyfold. Middle-income countries, including China, are experiencing particularly rapid growth in incidence.
Young breast cancer patients also have distinct features. The younger the patient, the higher the risk of disease development and recurrence. Genetic mutations, such as GATA3, are significantly more prevalent in younger breast cancer patients, occurring in over 40% of cases, several times higher than in older patients. Germline mutations are also more common in young patients. The current definition of young breast cancer includes patients under 40, but we are considering introducing a subcategory for extremely young breast cancer, defined as patients under 35. This subgroup has significantly poorer prognoses and distinct genetic profiles compared to other age groups.
These findings highlight the importance of focusing on young breast cancer, raising awareness, enhancing early detection rates, and maximizing opportunities for cure and recovery.
3. Oncology Frontier: What challenges have you encountered in promoting standardized care for young breast cancer in China, and what are your future plans and goals?
Dr. Qiang Liu: Since the release of the China Young Breast Cancer Diagnosis and Treatment Consensus, it has garnered significant attention and support from both colleagues and patients. While we have faced few major challenges, there is always room for improvement.
Looking ahead, we plan to continue interdisciplinary collaboration with specialists in gynecology and reproductive medicine to provide holistic management for young breast cancer patients, ensuring their survival and quality of life. We also aim to strengthen psychological support and integrate elements of traditional Chinese medicine and psychotherapy to create a comprehensive support system for patients. Another priority is to remain updated on the latest research, continually refining the China Young Breast Cancer Diagnosis and Treatment Consensus and developing more accessible, patient-friendly versions to help patients better understand their treatment and recovery options.
Our overarching goal is to provide the best possible medical care and support for young breast cancer patients, enabling them to achieve full recovery.
About Dr. Qiang Liu
Dr. Qiang Liu is a renowned expert in breast cancer, serving as a professor, chief physician, and doctoral supervisor. He is the director of surgery at Sun Yat-sen Memorial Hospital, Sun Yat-sen University and the executive vice president of the Yixian Breast Cancer Hospital. He also leads the Breast Cancer Center and Breast Surgery Department. A former lecturer at Harvard University’s Dana-Farber Cancer Institute, he has pioneered liquid biopsy and immunotherapy applications in breast cancer treatment. He spearheaded the China Young Breast Cancer Diagnosis and Treatment Consensus and is widely recognized for his expertise in breast cancer diagnosis, surgery, and comprehensive treatment, particularly for challenging breast-conserving surgeries, young breast cancer, and triple-negative breast cancer.
