Breast cancer surgery for young women

Young women with breast cancer, a group that typically has more severe disease than older women, have similar outcomes whether they are managed with breast-conserving therapy or with mastectomy.Unlike mastectomy, breast-conserving therapy (BCT) does not involve the removal of the entire breast; only the part containing the cancer is removed. Patients treated with BCT are also often given radiation therapy and chemotherapy.Previous studies have established the equivalence of BCT and mastectomy in middle-aged and older women, but it was unclear if this also applied to women younger than 35 years. To investigate this, researchers from the Statens Serum Institut in Copenhagen, Denmark, assessed the outcomes of more than 9,000 women who were diagnosed with breast cancer before 50 years of age and treated with either breast-conserving therapy (BCT) or mastectomy. Of the 719 women who were younger than 35 years at diagnosis, 500 underwent mastectomy and 219 received BCT.

Consistent with previous reports, women younger than 35 years were more likely than older women to have large cancers with spread to the lymph nodes. Moreover, younger women were also more likely to receive BCT than older women.They found that young women treated with BCT were about five times more likely to experience a return of their cancer than their older counterparts. Still, as compared with mastectomy, BCT was not linked to worsened survival in any of the age groups. The comparable survival outcomes held true when the analysis was limited to women with small tumours. 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 mastectomy.

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