Details

Autor(en) / Beteiligte

• Cao, Jeffrey Q., MD, MBA, FRCPC
• Truong, Pauline T., MD, FRCPC
• Olivotto, Ivo A., MD, FRCPC
• Olson, Robert, MD, FRCPC, MSc
• Coulombe, Genevieve, MD, FRCPC
• Keyes, Mira, MD, FRCPC
• Weir, Lorna, MD, FRCPC
• Gelmon, Karen, MD, FRCPC
• Bernstein, Vanessa, MD, FRCPC
• Woods, Ryan, MSc
• Speers, Caroline, BA
• Tyldesley, Scott, MD, FRCPC

Titel

Should Women Younger Than 40 Years of Age With Invasive Breast Cancer Have a Mastectomy?: 15-Year Outcomes in a Population-Based Cohort

Ist Teil von

• International journal of radiation oncology, biology, physics, 2014-11, Vol.90 (3), p.509-517

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2014

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose Optimal local management for young women with early-stage breast cancer remains controversial. This study examined 15-year outcomes among women younger than 40 years treated with breast-conserving surgery plus whole-breast radiation therapy (BCT) compared with those treated with modified radical mastectomy (MRM). Methods and Materials Women aged 20 to 39 years with early-stage breast cancer diagnosed between 1989 and 2003 were identified in a population-based database. Primary outcomes of breast cancer–specific survival (BCSS), overall survival (OS) and secondary outcomes of local relapse–free survival (LRFS), locoregional relapse–free survival (LRRFS), and distant relapse–free survival (DRFS) were calculated using Kaplan-Meier methods and compared between BCT and MRM cohorts using log-rank tests. A planned subgroup analysis was performed on patients considered “ideal” for BCT (ie, T1N0, negative margins and no extensive ductal carcinoma in situ) and in whom local therapy may have the largest impact on survival because of low systemic risk. Results 965 patients were identified; 616 had BCT and 349 had MRM. The median follow-up time was 14.4 years (range, 8.4-23.3 years). Overall, 15-year rates of BCSS (76.0% vs 74.1%, P =.62), OS (74.2% vs 73.0%, P =.75), LRFS (85.4% vs 86.5%, P =.95), LRRFS (82.2% vs 81.6%, P =.61), and DRFS (74.4% vs 71.6%, P =.40) were similar between the BCT and MRM cohorts. In the “ideal” for BCT subgroup, there were 219 BCT and 67 MRM patients with a median follow-up time of 15.5 years. The 15-year BCSS (86.1% vs 82.9%, P =.57), OS (82.6% vs 82.9%, P =.89), LRFS (86.2% vs 84.2%, P =.50), LRRFS (83.1% vs 78.3%, P =.24), and DRFS (84.8% vs 79.1%, P =.17) were similar in the BCT and MRM cohorts. Conclusions This population-based analysis with long-term follow-up confirmed that women younger than 40 years treated with BCT had similar 15-year outcomes compared with MRM. Young age alone is not a contraindication to BCT.