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?

Full Record
Other Related Research

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.

Copy to clipboard


                    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.

Copy to clipboard


                    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.

Copy to clipboard


                    
@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}

}

Copy to clipboard

Journal Article:

DOI: 10.1016/j.ijrobp.2006.11.032

Other availability

Find in Google Scholar

Search WorldCat to find libraries that may hold this journal

Save / Share:

Export Metadata

Save to My Library

Similar records in OSTI.GOV collections:

Similar Survival With Breast Conservation Therapy or Mastectomy in the Management of Young Women With Early-Stage Breast Cancer

Journal Article Mahmood, Usama, E-mail: usama.mahmood@gmail.com ; Morris, Christopher ; Neuner, Geoffrey ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: To evaluate survival outcomes of young women with early-stage breast cancer treated with breast conservation therapy (BCT) or mastectomy, using a large, population-based database. Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER) database, information was obtained for all female patients, ages 20 to 39 years old, diagnosed with T1-2 N0-1 M0 breast cancer between 1990 and 2007, who underwent either BCT (lumpectomy and radiation treatment) or mastectomy. Multivariable and matched pair analyses were performed to compare overall survival (OS) and cause-specific survival (CSS) of patients undergoing BCT and mastectomy. Results: A total of 14,764 women weremore »« less
DOI: 10.1016/J.IJROBP.2011.10.075
The Incidence of Arm Edema in Women With Breast Cancer Randomized on the National Surgical Adjuvant Breast and Bowel Project Study B-04 to Radical Mastectomy Versus Total Mastectomy and Radiotherapy Versus Total Mastectomy Alone

Journal Article Deutsch, Melvin ; University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA ; Land, Stephanie ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: To determine the incidence and factors associated with the development of arm edema in women who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-04. Methods and Materials: Between 1971 and 1974, the NSABP protocol B-04 randomized 1,665 eligible patients with resectable breast cancer to either (1) the Halstead-type radical mastectomy; (2) total mastectomy and radiotherapy to the chest wall, axilla, supraclavicular region, and internal mammary nodes if by clinical examination axillary nodes were involved by tumor; and (3) for patients with a clinically uninvolved axilla, a third arm, total mastectomy alone. Measurements of themore »« less
DOI: 10.1016/j.ijrobp.2007.07.2376
In the Modern Treatment Era, Is Breast Conservation Equivalent to Mastectomy in Women Younger Than 40 Years of Age? A Multi-Institution Study

Journal Article Frandsen, Jonathan ; Ly, David ; Cannon, George ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: Mastectomy is often recommended for women ≤40 years of age with breast cancer, as young women were under-represented in the landmark trials comparing breast conservation therapy (BCT) to mastectomy. We hypothesized that, in the modern treatment era, BCT and mastectomy result in equivalent local control rates in young women. Methods and Materials: Breast cancer cases arising between 1975 and 2013 in women ≤40 years old were collected from the tumor registries of 2 large healthcare systems in Utah. Kaplan-Meier estimates and Cox proportional hazards models were used to analyze freedom from locoregional recurrence (FFLR), overall survival (OS), and relapse-free survival (RFS).more »« less
DOI: 10.1016/J.IJROBP.2015.08.044
Ipsilateral breast tumor recurrence after breast conservation therapy: Outcomes of salvage mastectomy vs. salvage breast-conserving surgery and prognostic factors for salvage breast preservation

Journal Article Alpert, Tracy E. ; Kuerer, Henry M. ; Arthur, Douglas W. ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: To compare outcomes of salvage mastectomy (SM) and salvage breast-conserving surgery (SBCS) and study the feasibility of SBCS. Methods and Materials: Of 2,038 patients treated with breast-conserving therapy at Yale-New Haven Hospital before 1999, 166 sustained an ipsilateral breast tumor recurrence (IBTR). Outcomes and prognostic factors of patients treated with SM or SBCS were compared. Patients were considered amenable to SBCS if the recurrence was localized on mammogram and physical examination, and had pathologic size <3 cm, confined to the biopsy site, without skin or lymphovascular invasion, and with {<=}3 positive nodes. Results: Of the 146 patients definitively managedmore »« less
DOI: 10.1016/j.ijrobp.2005.02.035
Ten-Year Recurrence Rates in Young Women With Breast Cancer by Locoregional Treatment Approach

Journal Article Beadle, Beth M. ; Woodward, Wendy A. ; Tucker, Susan L. ; ... - International Journal of Radiation Oncology, Biology and Physics

Purpose: Young women with breast cancer have higher locoregional recurrence (LRR) rates than older patients. The goal of this study is to determine the impact of locoregional treatment strategy, breast-conserving therapy (BCT), mastectomy alone (M), or mastectomy with adjuvant radiation (MXRT), on LRR for patients 35 years or younger. Methods and Materials: Data for 668 breast cancers in 652 young patients with breast cancer were retrospectively reviewed; 197 patients were treated with BCT, 237 with M, and 234 with MXRT. Results: Median follow-up for all living patients was 114 months. In the entire cohort, 10-year actuarial LRR rates varied bymore »« less
DOI: 10.1016/j.ijrobp.2008.04.078

Similar Records