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. 2015 Oct;15(5):390-7.
doi: 10.1016/j.clbc.2015.03.012. Epub 2015 Apr 2.

Equivalent Survival With Mastectomy or Breast-conserving Surgery Plus Radiation in Young Women Aged < 40 Years With Early-Stage Breast Cancer: A National Registry-based Stage-by-Stage Comparison

Jason C Ye  1 , Weisi Yan  2 , Paul J Christos  3 , Dattatreyudu Nori  2 , Akkamma Ravi  4
Affiliations

Equivalent Survival With Mastectomy or Breast-conserving Surgery Plus Radiation in Young Women Aged < 40 Years With Early-Stage Breast Cancer: A National Registry-based Stage-by-Stage Comparison

Jason C Ye et al. Clin Breast Cancer. 2015 Oct.

Abstract

Background: Studies have shown that young patients with early-stage breast cancer (BC) are increasingly undergoing mastectomy instead of breast-conserving therapy (BCT) consisting of lumpectomy and radiation. We examined the difference in outcomes in young women (aged < 40 years) who had undergone BCT versus mastectomy.

Materials and methods: The Surveillance, Epidemiology, and End Results database was queried for women aged < 40 years with stage I or II invasive BC treated with surgery from 1998 to 2003. Breast cancer-specific survival (BCSS) and overall survival (OS) were evaluated using Kaplan-Meier survival analysis and the log-rank test between treatment types.

Results: Of the 7665 women, 3249 received BCT and 2627 underwent mastectomy without radiation. When separated by stage (I, IIA, and IIB), with a median follow-up duration of 111 months, the BCT and mastectomy-only groups showed no statistically significant differences in BCSS and OS. Overall, the age group of 35 to 39 years (66% of total) was associated with better 10-year BCSS (88%) and OS (86.1%) compared with the younger patients aged 20 to 34 years (34% of total). The latter group had a 10-year BCSS and OS of 84.1% and 82.3%, respectively (P < .001 for both BCSS and OS). However, when the patients of each age group were further subdivided by stage, the BCT group continued to show noninferior BCSS and OS compared with the mastectomy group in all subgroups.

Conclusion: The results of our study suggest that although young age might be a poor prognostic factor for BC, no evidence has shown that these patients will have better outcomes after mastectomy than after BCT.

Keywords: Breast-conserving therapy; Disease specific survival; Lumpectomy; Radiotherapy; SEER.

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Figures

Figure 1
Figure 1
Patient outcome by treatment type, stratified by stage Abbreviations: BCSS = Breast Cancer Specific Survival, BCT = Breast conserving therapy, RT = Radiation therapy
Figure 2
Figure 2
Patient outcome by age group and treatment type Abbreviations: BCSS = Breast Cancer Specific Survival, BCT = Breast conserving therapy, RT = Radiation therapy
Figure 3
Figure 3
Patient outcome by treatment type in Stage IIB patients ages 20–34 Abbreviations: BCSS = Breast Cancer Specific Survival, BCT = Breast conserving therapy, RT = Radiation therapy Note: No difference in BCSS or Overall Survival by treatment type was observed in Stages I and IIA for the same age group. There was also no difference in BCSS or Overall Survival by treatment type observed in Stages I, IIA, and IIB for patients in age group 35–39.
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References

    1. Fisher B, Anderson S, Bryant J, et al. Twenty-Year Follow-up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy plus Irradiation for the Treatment of Invasive Breast Cancer. N Engl J Med. 2002;347:1233–1241. - PubMed
    1. (EBCTCG) EBCTCG. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–2106. - PubMed
    1. (EBCTCG) EBCTCG. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials. Lancet. 2011;378:1707–16. - PMC - PubMed
    1. DiSipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 2013;14(6):500–515. - PubMed
    1. Curran D, van Dongen J, Aaronson N, et al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group. Eur J Cancer. 1998;34(3):307–14. - PubMed

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