Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?

doi:10.1016/j.ijrobp.2006.11.032

Title: Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?

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Abstract

Purpose: To examine whether modified radical mastectomy (MRM) improves outcomes compared with breast-conserving treatment (BCT) in young women. Methods and Materials: Women aged 20-49 years, diagnosed with early breast cancer between 1989 and 1998, were identified. Management with BCT or MRM was compared for local (L), locoregional (LR), and distant relapse-free survival (DRFS) and breast cancer-specific survival (BCSS) by age group (20-39 years, 40-49 years). The analysis was repeated for patients considered 'ideal' candidates for BCT: tumor size {<=}2 cm, pathologically negative axillary nodes, negative margins, and no reported ductal carcinoma in situ. Results: A total of 1,597 women received BCT, and 801 had MRM. After a median follow-up of 9.0 years, the outcomes (L, LR, BCSS) were worse for the younger age group; however, the outcomes were not statistically different by type of local treatment. For women aged 20-39 years considered 'ideal' for BCT, those treated with BCT had slightly lower LRFS compared with those treated with MRM (p = 0.3), but DRFS and BCSS were similar. Conclusions: A difference in LRFS at 10 years potentially favored MRM among women aged 20-39 years considered 'ideal' BCT candidates but was not statistically significant and did not translate into a noticeablemore »« less

Authors:

Coulombe, Genevieve ^[1]; Tyldesley, Scott ^[2]; Speers, Caroline B.A. ^[3]; Paltiel, Chuck M.Sc. ^[4]; Aquino-Parsons, Christina ^[1]; University of British Columbia, Vancouver, BC ^[5]; Bernstein, Vanessa ^[6]; University of British Columbia, Vancouver, BC ^[5]; Truong, Pauline T. ^[3]; Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC ^[5]; University of British Columbia, Vancouver, BC ^[5]; Keyes, Mira ^[1]; University of British Columbia, Vancouver, BC ^[5]; Olivotto, Ivo A. ^[3]; Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC ^[5]; University of British Columbia, Vancouver, BC ^[5]

Radiation Therapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada)
Radiation Therapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada) and Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC (Canada) and University of British Columbia, Vancouver, BC (Canada). E-mail: styldesl@bccancer.bc.ca
Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC (Canada)
Population and Preventive Oncology Program, British Columbia Cancer Agency (BCCA), Vancouver, BC (Canada)
(Canada)
Systemic Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC (Canada)

Publication Date:: Sun Apr 01 00:00:00 EDT 2007

OSTI Identifier:: 20951569

Resource Type:: Journal Article

Resource Relation:: Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 5; Other Information: DOI: 10.1016/j.ijrobp.2006.11.032; PII: S0360-3016(06)03505-X; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)

Country of Publication:: United States

Language:: English

Subject:: 62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; EFFICIENCY; MAMMARY GLANDS; RADIOPROTECTIVE SUBSTANCES; RADIOTHERAPY; SURGERY; WOMEN

Citation Formats


                    Coulombe, Genevieve, Tyldesley, Scott, Speers, Caroline B.A., Paltiel, Chuck M.Sc., Aquino-Parsons, Christina, University of British Columbia, Vancouver, BC, Bernstein, Vanessa, University of British Columbia, Vancouver, BC, Truong, Pauline T., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, University of British Columbia, Vancouver, BC, Keyes, Mira, University of British Columbia, Vancouver, BC, Olivotto, Ivo A., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, and University of British Columbia, Vancouver, BC. Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?.  United States: N. p., 2007. 
        Web.  doi:10.1016/j.ijrobp.2006.11.032.

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                    Coulombe, Genevieve, Tyldesley, Scott, Speers, Caroline B.A., Paltiel, Chuck M.Sc., Aquino-Parsons, Christina, University of British Columbia, Vancouver, BC, Bernstein, Vanessa, University of British Columbia, Vancouver, BC, Truong, Pauline T., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, University of British Columbia, Vancouver, BC, Keyes, Mira, University of British Columbia, Vancouver, BC, Olivotto, Ivo A., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, & University of British Columbia, Vancouver, BC. Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?.  United States.  doi:10.1016/j.ijrobp.2006.11.032.

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                    Coulombe, Genevieve, Tyldesley, Scott, Speers, Caroline B.A., Paltiel, Chuck M.Sc., Aquino-Parsons, Christina, University of British Columbia, Vancouver, BC, Bernstein, Vanessa, University of British Columbia, Vancouver, BC, Truong, Pauline T., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, University of British Columbia, Vancouver, BC, Keyes, Mira, University of British Columbia, Vancouver, BC, Olivotto, Ivo A., Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC, and University of British Columbia, Vancouver, BC. Sun .  
        "Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?".  United States.  
        doi:10.1016/j.ijrobp.2006.11.032.

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@article{osti_20951569,

  title        = {Is Mastectomy Superior to Breast-Conserving Treatment for Young Women?},

  author       = {Coulombe, Genevieve and Tyldesley, Scott and Speers, Caroline B.A. and Paltiel, Chuck M.Sc. and Aquino-Parsons, Christina and University of British Columbia, Vancouver, BC and Bernstein, Vanessa and University of British Columbia, Vancouver, BC and Truong, Pauline T. and Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC and University of British Columbia, Vancouver, BC and Keyes, Mira and University of British Columbia, Vancouver, BC and Olivotto, Ivo A. and Radiation Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC and University of British Columbia, Vancouver, BC},

  abstractNote = {Purpose: To examine whether modified radical mastectomy (MRM) improves outcomes compared with breast-conserving treatment (BCT) in young women. Methods and Materials: Women aged 20-49 years, diagnosed with early breast cancer between 1989 and 1998, were identified. Management with BCT or MRM was compared for local (L), locoregional (LR), and distant relapse-free survival (DRFS) and breast cancer-specific survival (BCSS) by age group (20-39 years, 40-49 years). The analysis was repeated for patients considered 'ideal' candidates for BCT: tumor size {<=}2 cm, pathologically negative axillary nodes, negative margins, and no reported ductal carcinoma in situ. Results: A total of 1,597 women received BCT, and 801 had MRM. After a median follow-up of 9.0 years, the outcomes (L, LR, BCSS) were worse for the younger age group; however, the outcomes were not statistically different by type of local treatment. For women aged 20-39 years considered 'ideal' for BCT, those treated with BCT had slightly lower LRFS compared with those treated with MRM (p = 0.3), but DRFS and BCSS were similar. Conclusions: A difference in LRFS at 10 years potentially favored MRM among women aged 20-39 years considered 'ideal' BCT candidates but was not statistically significant and did not translate into a noticeable difference in DRFS or BCSS. Our data suggest that young age alone is not a contraindication to BCT.},

  doi          = {10.1016/j.ijrobp.2006.11.032},

  journal      = {International Journal of Radiation Oncology, Biology and Physics},

  number       = 5,

  volume       = 67,

  place        = {United States},

  year         = {Sun Apr 01 00:00:00 EDT 2007},

  month        = {Sun Apr 01 00:00:00 EDT 2007}

}

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DOI: 10.1016/j.ijrobp.2006.11.032

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