Purpose: The early detection of breast cancer in women under the age of 40 has posed significant challenges. This can be attributed in part to the limited research conducted on the breast cancer in this age group, particularly with regards to large sample sizes. We aimed to address this gap by analyzing and comparing the ultrasound imaging and pathological characteristics of breast cancer in women aged under 40 and those aged 40 and above. Methods: A retrospective assessment was conducted to examine the ultrasound imaging and clinicopathologic characteristics of 555 women with surgically confirmed breast cancers. The patient cohort consisted of 160 individuals below the age of 40 and 395 individuals aged 40 years and above. Results: Our study identified the breast cancer in patients under 40 years was more likely to show regular shape (p = 0.043) compared with tumors in patients who were 40 years and over. Furthermore, in young female patients (<40 years), irregular shape was correlated with the HER2-enriched type (p = 0.02), circumscribed margin (p = 0.001), and a lack of calcifications (p = 0.02) were associated with the triple-negative type. In another group (≥40 years), only a lack of calcifications (p = 0.003) were associated with the triple-negative type. Conclusion: Breast cancer in women under the age of 40 exhibits distinct ultrasonographic characteristics patterns that vary across different immunophenotypes, which may provide certain predictive information for physicians.

Ensuring proper menstrual hygiene management remains a significant challenge for young women in India. The term \"exclusive use of hygienic period products during menstruation\" refers to relying solely on period products like sanitary pads, tampons, or menstrual cups. Poor menstrual hygiene practices not only increase the risk of reproductive tract infections but also lead to various negative health outcomes, including discomfort and potential complications. This study explores factors associated with the exclusive use of period products during menstruation aged 15-24, investigates geographic disparities, examines rural-urban gaps, and assesses inequality in India. Utilizing data from the fifth National Family Health Survey (NFHS-5), responses from 2,41,180 women aged 15 to 24 were analysed using logistic regression and multivariate decomposition analyses to explore socioeconomic predictors. Moran\'s I statistics also assessed spatial dependency, while Lorenz curves and Gini coefficients measured inequality. Quintile and LISA maps visualized regional disparities. The study found that 76.15% of women in India reported exclusive use of hygienic period products during menstruation. Rural areas reported a lower percentage of exclusive use of hygienic period products (72.32%) during menstruation compared to urban areas (89.37%). Key factors associated with the exclusive use of hygienic period products among 15-24-year-old women in India include age, education, place of residence, wealth, access to media, and healthcare discussions. Geographically, central districts exhibited the lowest coverage (< 65%), while the Southern region reported the highest (> 85). The GINI coefficient of 0.39 highlighted moderate inequality in distribution. Decomposition analysis revealed that household wealth contributed 49.25% to rural-urban differences, followed by education (13.41%), media access (7.97%), and region (4.97%). This study highlights significant regional disparities and low utilization of hygienic period products among young women in India, particularly in central districts. Policymakers should prioritize interventions targeting these regions, addressing socio-economic disparities. Strategies to promote education, improve media access, and enhance household wealth can facilitate menstrual hygiene adoption. Initiatives to reduce sanitary napkin costs and increase accessibility, particularly in rural areas, are crucial to mitigating geographical disparities nationwide.

OBJECTIVE: In 2012, updated ASCCP management guidelines for abnormal cervical cytology recommended observation rather than immediate referral to colposcopy for low-grade abnormalities in women ages 21-24. We evaluated the impact of these guidelines on changes in colposcopy procedure rates among young women.
METHODS: We analyzed administrative and claims data from the largest statewide family planning program between July 2011 and June 2015. Using a difference-in-differences approach, we estimated changes in colposcopy procedure rates among women ages 21-24 years before and after the 2012 ASCCP management guidelines, relative to a comparison group of women ages 25-44.
RESULTS: Our analysis included 333,977 women from 216 primary care provider sites. After publication of the 2012 ASCCP management guidelines, colposcopy rates significantly declined from 6.70% (95% CI 6.21-7.19) to 3.94% (95% CI 3.60-4.29) among women ages 21-24 and from 4.35% (95% CI 4.03-4.67) to 3.53% (3.25-3.80) among women over 24 years. These declines correspond to a 1.93 percentage point reduction (95% CI 1.62-2.25; p < 0.001) in colposcopy rate among women 21-24 vs. over 24 years, or a two-fold relative reduction. Among women ages 21-24, colposcopy receipt was associated with speaking primarily English vs. non-English (OR 1.46, 95% CI 1.35-1.57), having a cervical cytology test within the past year vs. not (OR 1.55, 95% CI 1.44-1.66), and receiving care from a public vs. private provider (OR 1.31, 95% CI 1.06-1.62).
CONCLUSIONS: Colposcopy procedure rates among young women significantly declined following publication of the 2012 management guidelines, which has implications for reducing potential harms of overtreatment.

OBJECTIVE: Young women with breast cancer (YWBC) face unique survivorship challenges due to being diagnosed at a more vulnerable stage in life and receiving gonadotoxic and/or antiestrogen therapy during their reproductive years. The purpose of this article is to elaborate on these challenges and demonstrate how specialized supportive care programs tailored specifically for YWBC, can greatly facilitate the provision of interventions to address these challenges.
METHODS: The databases used were PubMed and Medline. Articles included those that involve young women with breast cancer and survivorship care needs.
UNASSIGNED: Compared to older breast cancer patients, YWBC generally require more aggressive treatments and are more likely to have a hereditary basis for their disease. Common challenges include childbearing concerns, premature menopause, body image issues, excessive fear of cancer recurrence, difficulties with intimate relationships, and financial toxicity. A possible solution to addressing these needs are longitudinal care in a specialized supportive care program, such as the PYNK Program for Young Women with Breast Cancer in Toronto, Ontario, Canada. Examples of such interventions include fast-tracking fertility preservation, aggressive management of symptoms of iatrogenic menopause, peer support groups, as well as individualized psycho-social support for the patient and her family.
CONCLUSIONS: By addressing the unique needs of this population, supportive care programs can play a crucial role in empowering young women with breast cancer to cope with the physical, emotional, and practical challenges they may face during and after treatment. The limitation lies in resource availability and funding for sustainability. Ongoing research is required to better understand the needs of YWBC patients in survivorship and ensure the sustainability of programs designed to address these challenges.

OBJECTIVE: Systemic cancer treatments pose threats to fertility, leading to concerns regarding fertility and parenthood in young adult women with breast cancer (YAWBC). This systematic review aimed to synthesize existing evidence on reproductive concerns (RCs) among YAWBC and identify areas where further research in needed.
METHODS: A systematic review was conducted. Nine English and Chinese databases were searched for studies from inception to June 2023. A meta-analysis was employed to pool RC levels measured using the Reproductive Concerns After Cancer scale (RCAC scale; possible total scores: 18-90). Narrative synthesis was conducted in cases where a meta-analysis could not be performed.
RESULTS: Twenty-four cross-sectional studies across seven countries were included in this review. The prevalence of RCs among YAWBC ranged from 21.75% to 80%. The pooled mean total score on the overall RCAC scale was 55.84 (95% confidence interval: 53.26-58.43). \"Personal health,\" \"child\'s health,\" and \"fertility potential\" were the top three types of RCs among YAWBC. Sociodemographic, clinical, and psychosocial factors were found to be associated with RCs among YAWBC. Additionally, significant correlations among RCs, nonadherence to treatment, depression, and quality of life were also identified among YAWBC.
CONCLUSIONS: RCs are a common issue among YAWBC, and age, parenthood status, fertility desire, and chemotherapy treatment are important factors associated with RCs among these women. Further research is needed to clarify RC-related factors to provide evidence aimed at tailoring interventions to mitigate RCs among YWBC.

BACKGROUND: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia.
METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis.
RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services.
CONCLUSIONS: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

A scarcity of research has examined the effect of breast cancer awareness (BCA) interventions among young women (18-50 years). This overlooks important differences that may affect BCA levels such as education preferences within this younger cohort. Younger women are more likely than older women to present with aggressive subtypes of breast cancer if they develop the disease, and at a more advanced stage translating into poorer survival. It is therefore worthy to investigate which interventions have a significantly positive effect on BCA within this cohort. Five studies were deemed eligible for review. Despite differing intervention methods, theoretical applications and awareness targets, positive outcomes were reported across all designs. However, the evidence is weak in investigating the effectiveness of BCA interventions on this cohort and is considered as inconclusive with such a small number of available studies to review, highlighting a need for further research in this area.

The prevalence and influence of gangs on adolescents and young adults remain a concern in Western Cape, South Africa-particularly as they have one of the largest gang presence. While less attention has been focused on young women, there is a need to elucidate the relationship between gang exposure and health behaviors, such substance use, in addition to understanding whether becoming a caregiver impacts this relationship. This study uses baseline data from 496 participants enrolled in a NIDA-funded R01 trial that recruited young women aged 16 to 19 who were out of school and reported recent alcohol or other drug use and sexual risk behavior. At enrollment, a risk behavior survey was administered, and urine drug screening was conducted. Multivariable logistic regression analyses were conducted to examine baseline associations between childbirth, a gang exposure index based on eight items, and positive drug screens of the most prevalent drugs in the Western Cape (marijuana, methaqualone, and methamphetamine). At enrollment, approximately 39% of the sample had a positive urine screen for marijuana, 17% for methaqualone, and 11% for methamphetamine. Additionally, 28% had ever given birth. While only 6% reported ever being a member of a gang, most reported exposure to gangs through their physical and social environments. For all three drugs, gang exposure was associated with statistically significantly higher odds of a positive screen. Every one-point increase in the gang exposure index was associated with a 31% increase in the odds of a positive marijuana screen (p < .001), a 26% increase for methaqualone (p = 0.005) and a 37% increase in the odds of a positive methamphetamine screen (p < .001). Ever given birth was associated with lower odds of marijuana use (adjusted odds ratio [AOR]: 0.63; 95% CI: 0.42-0.96), but it was not associated with methaqualone or methamphetamine use. The findings suggest that exposure to gangs through young women\'s social and physical environment is positively associated with drug use. Childbirth was also protective for marijuana use, indicating there may be something unique about this type of drug, such as one\'s ability to more easily stop use. Although very few young women reported gang membership, a majority reported some exposure, indicating the need to address how pervasive this exposure is and the potential risk.

UNASSIGNED: To evaluate the impact of levonorgestrel-releasing intrauterine device (LNG-IUD) use on the incidence of acne in adolescents and young women.
UNASSIGNED: A narrative review was conducted in PubMed, Embase, Cochrane, and SciELO assessing the incidence of acne in adolescents and young women using LNG-IUD (13.5, or 19.5 mg, or 52 mg). Cohort, cross-sectional studies, clinical trials, and meta-analyses were included, without a date limit. Studies that didn\'t evaluate women in the age of interest were excluded. Only articles in English were selected.
UNASSIGNED: Nine articles were included in this narrative review. Only clinical trials, cohort studies, and cross-sectional studies were evaluated. Two cross-sectional studies evaluated the incidence of acne in women using any contraceptive methods, with the incidence of acne being 36% in women aged 17 to 47 using LNG-IUD in one study. In another study, acne incidence ranged from 2 to 8% in women using any contraceptive methods, with higher rates in younger women and LNG-IUD users. The incidence of acne varies and participants between 16 to 35 years were more likely to report new acne or worsening of pre-existing acne. In a prospective cohort study of women between 16 and 24 years, acne was a common adverse effect, with 44% in the first year.
UNASSIGNED: The data indicate variability in the incidence of acne among LNG-IUD users, with a higher prevalence observed in younger women. Further research should focus on the effects of LNG-IUD on acne in young populations, with rigorous study designs and consideration of previous contraceptive use.
The levonorgestrel-releasing intrauterine device (LNG-IUD) is an important tool in the prevention of unplanned pregnancies in adolescents and young women. Acne is a possible adverse effect that could lead to discontinuation of the method.

Oral PrEP is highly effective against the acquisition of HIV but is underutilised by young women. New options, like the monthly dapivirine vaginal ring (DVR) and injectable long-acting cabotegravir (CAB-LA), are emerging. However, little is known about young women\'s perceptions of these alternatives. This qualitative study explored perceptions of the attributes of PrEP technologies in South Africa. Young women accessing sexual health services were purposively selected to participate in 22 in-depth interviews, five focus group discussions and two workshops using the nominal group technique, between August 2022 and March 2023. A thematic approach guided by the diffusion of innovation attributes, including relative advantage, compatibility with the student\'s lives, complexity of the technology, and trialability, was used for data analysis. The DVR was the least preferred because of lower efficacy, the perceived complexity of inserting it in the vagina and some safety concerns. Oral PrEP, which some had tried and discontinued, was least compatible with students\' busy schedules. Integrating PrEP and contraceptives with similar return visit patterns could enhance service delivery. Intensive demand creation campaigns will be needed to increase PrEP utilisation and dispel myths about the vaginal ring.