Breast cancer in young women from Asia

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Published: 24 Jan 2018
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Dr Wu Jiong - Fudan University, Shanghai, China

Dr Jiong speaks with ecancer at the 10th BGICC in Cairo about the aetiology and management of breast cancer in Shanghai hospitals.

He describes the rates of disease development among young Asian women, and considers the drivers behind variation in disease onset across the globe.

For more on breast surgery for cancer patients, watch our interview with Prof Riccardo Audisio on European training and speciality here.

In developing countries we have encountered so many young age breast cancer patients. Comparing to the Western countries, in our country we had around 5-7% of young age patients, which is younger than 40 years old or 35 years old. Especially in our cancer centre recently we are facing that around 14-15% of younger age breast cancer patients. I think we need a special treatment for those patients because they are very young, they are facing their working and they are considering about fertility and some psychosocial pressures according to the disease.

We find some very interesting and important results from the systemic treatment for those patients and it's improving the survival benefit for those patients. So, as a surgeon, we should combine all the surgical strategies with the systemic treatment. So when I gave the topic about young age breast cancer patients I focussed on these issues.


Have immunotherapies changed attitudes towards breast cancer treatments?

Immunotherapy is due on the trials for breast cancer patients, especially for those triple negative patients and for those some HER2 positive breast cancer patients we are looking forward to see many important improvements of these results from the trials.

Do you think that a targeted lead approach will be more beneficial for HER2 patients?

Not only HER2 positive but also hormonal receptor positive patients we see very huge improvements for these targeting therapies, even without chemotherapy agents. Those targeting therapies can help a lot to improve the survival rate or the progression free survival time.

Have there been any changes in patients' attitudes towards surgery?

We see lots of patients and especially younger patients, they are seeking for breast conserving surgery in our country and in my city. The breast conserving rate is increasing rapidly in our centre and also the breast reconstruction, especially those immediate reconstructions for those patients. We still have unmet needs from our society because breast surgeon is a new area, it's a new sub-specialty in our country and many surgeons are from general surgeons, they lack enough pre-training courses for the oncoplastic or plastic surgeries. So to improve the surgical quality and the standard for these patients we need to have more training courses or training centres for our society to do more for our patients.

Is that attitude shared worldwide?

Yes, yes, I just sat beside Professor Riccardo, he is from Liverpool University, and he is a very experienced surgeon. He also mentioned in the UK, also in other European countries, they are trying to set up a kind of standard training course for young specialties, especially breast surgeons. They provide some grounds to support this kind of training.

Do you have any advice for someone looking to get into breast surgery?

In my experience, because I'm at the beginning of the residency, I'm a thoracic surgeon and we do thoracic surgery and breast surgery together. It's very common that young surgeons have been training in a general surgery background and then they were moved to breast surgery speciality. I think it should take about one or two years in this specialty and take some rounds in the plastic surgery department. Also we need to invite several very experienced surgeons to give a live surgery training course for senior young surgeons. We try to set up several training centres in China, in mainland China, to recruit and to prepare and provide several chances every year for local surgeons. Because China is very big it's very important to provide several centres across the country.

Any final thoughts?

This is a very successful meeting to help us to meet many specialties and experience speakers from all over the world. We have very good friends; I know like Prof. Omar Z. Youssef before and I know several very experienced surgeons. We can exchange our experiences and we had a conclusion that breast surgery is a very unique surgical oncology branch and we need to do something to facilitate all this training and to promote the standard of the breast surgery for our patients.