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

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1];  [2];  [3];  [4];  [1];  [5];  [3];  [1];  [3]
  1. Radiation Therapy Program, British Columbia Cancer Agency, Vancouver, BC (Canada)
  2. 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)
  3. Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver, BC (Canada)
  4. Population and Preventive Oncology Program, British Columbia Cancer Agency (BCCA), Vancouver, BC (Canada)
  5. Systemic Therapy Program, BCCA, Vancouver Island Centre, Victoria, BC (Canada)

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.

OSTI ID:
20951569
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 67, 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); ISSN 0360-3016
Country of Publication:
United States
Language:
English

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