Editorial Note: The 2024 Yixian Breast Cancer Conference and the 2nd China Young Breast Cancer Consensus Conference, held on December 27–28 in Guangzhou, focused on cutting-edge topics such as the changing epidemiology of young breast cancer, screening strategies, the impact of genetic mutations, treatment, and rehabilitation. During the conference, Dr. Yaping Yang from Sun Yat-sen Memorial Hospital delivered a lecture on “Genetic Mutations in Young Breast Cancer Patients,” addressing key issues such as the impact of genetic mutations on cure rates and whether routine referrals to breast specialists are necessary for BRCA-mutated ovarian cancer patients. In an interview with Oncology Frontier, Professor Yang discussed the characteristics of young breast cancer patients and provided personalized treatment recommendations for those carrying genetic mutations.

Oncology Frontier: What are the characteristics of young breast cancer patients?

Dr. Yaping Yang:In China, young breast cancer patients make up a significant proportion of the total breast cancer population. According to data from Sun Yat-sen Memorial Hospital, approximately 20% of breast cancer patients are young individuals. This group has a relatively high risk of carrying hereditary susceptibility gene mutations.

For this unique population, it is essential to address their broader social needs alongside standard treatment. For instance, fertility preservation is a major concern. For young breast cancer patients carrying susceptibility genes, we offer comprehensive genetic counseling and, when needed, assistive reproductive technologies to help prevent passing pathogenic mutations to the next generation.

Additionally, young patients are often deeply concerned about the appearance of their breasts. We encourage open communication with surgical teams to select the most suitable surgical approach that preserves breast aesthetics as much as possible. Many of these patients also aim to return to their family and professional lives. Therefore, support from family, society, and colleagues plays a critical role in their recovery and well-being.

Oncology Frontier: What personalized treatment recommendations do you have for young breast cancer patients with genetic mutations?

Dr. Yaping Yang:For young breast cancer patients with genetic mutations, we begin by providing systematic genetic counseling, which includes constructing a family pedigree to comprehensively assess cancer risks within their family. For unaffected siblings or parents, we also recommend comprehensive evaluations. If feasible, we encourage family members to undergo genetic testing for specific mutation sites, as most familial mutations tend to cluster at the same site.

For tumors associated with BRCA1/2 mutations, such as breast and ovarian cancer, we recommend precise and sensitive screening methods, including breast MRI and pelvic MRI. These tools are especially valuable for women carrying these mutations and are actively encouraged.

For male carriers of BRCA1/2 mutations, there is an elevated risk of developing prostate cancer. We advise this group to begin prostate cancer screening around age 50, including ultrasound and PSA (prostate-specific antigen) testing. Early detection and intervention can significantly reduce cancer mortality rates in this population.

Dr. Yaping Yang

• Professor, Associate Chief Physician, PhD in Oncology, Master’s Supervisor
• Associate Chief Physician, Yixian Breast Cancer Institute, Sun Yat-sen Memorial Hospital
• Clinical Research Visiting Scholar, Johns Hopkins University School of Medicine
• Member, Breast Committee, Chinese Association of Female Physicians
• Executive Member, Cancer Screening and Early Diagnosis and Treatment Committee, Guangdong Anti-Cancer Association
• Executive Member, Cancer Early Screening and Diagnosis Committee, Guangdong Precision Medicine Society
• Executive Member, Breast Tumor Management Committee, Guangdong Medical Industry Association
• Member, Hereditary Tumor Committee, Guangdong Anti-Cancer Association
• Second Prize, Guangdong Science and Technology Progress Award (Second Contributor)
• Awarded “Outstanding Science Educator of Guangzhou” in 2023

Conclusion Dr. Yaping Yang’s insights highlight the unique challenges faced by young breast cancer patients, emphasizing the importance of addressing their genetic risks and providing personalized care. Her approach underscores the value of comprehensive genetic counseling, advanced screening techniques, and support systems to improve outcomes and quality of life for this vulnerable population.