Breast-conserving surgery does not worsen survival of young cancer patients

Young women with breast cancer – a group that typically has more aggressive disease and a higher rate of local recurrence than older women – have similar outcomes whether they are treated with breast-conserving therapy or modified radical mastectomy, new research suggests.

Previous reports have established the equivalence of these treatments in middle-aged and older women, but it was unclear if this also applied to women younger than 35 years.To investigate, Dr. Mads Melbye, from the Statens Serum Institut in Copenhagen, Denmark, and colleagues assessed the outcomes of more than 9000 women who were diagnosed with breast cancer before 50 years of age and treated with either breast-conserving therapy (BCT) or modified radical mastectomy (MRM). Of the 719 women who were younger than 35 years at diagnosis, 500 underwent MRM and 219 received BCT.The researchers’ findings are reported in the December 29th online issue of Cancer and will also appear in the March 1st print edition.Consistent with previous reports, women younger than 35 years were more likely than older women to have tumors > 2 cm in size (p = 0.007) and to have nodal disease (p = 0.002). Moreover, younger women were also more likely to receive BCT than older women (p < 0.001).Young women treated with BCT were about five times more likely to experience a local recurrence than their older counterparts. Still, as compared with MRM, BCT was not tied to worsened survival in any of the age groups. The comparable survival outcomes held true when the analysis was limited to women with tumors no greater than 2 cm in size."Although the high frequency of local recurrence among younger patients represents a problem in itself, the current study did not find survival to be significantly different for young women who received BCT compared with those who underwent MRM," the investigators state. (Source: Cancer 2004;100: Reuters Health: December 29, 2003: Oncolink)