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

Coulombe, Geneviève; Tyldesley, Scott; Speers, Caroline; Paltiel, Chuck; Aquino‐Parsons, Christina; Bernstein, Vanessa; Truong, Pauline T.; Keyes, Mira; Olivotto, Ivo A.

doi:10.1016/j.ijrobp.2006.11.032

Cited by 70 publications

(47 citation statements)

References 13 publications

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“…Punglia et al emphasize the importance of a careful selection of patients for BCT as this strategy leads to a decrease in breast-cancer and overall mortality [24]. Although the proportion of local relapses is higher after BCT, studies among young women show no difference in distant recurrence-free survival [17,15]. Neither did we find a significant difference with a distant recurrence-free survival at 10 year of 67.0% after mastectomy and 71.1% after BCT.…”

mentioning

confidence: 53%

“…Even by pooling data derived from all available trials, the number of young patients would be too small to draw firm conclusions. Therefore, evidence for the safety of BCT was searched in a few non-randomized studies [15][16][17]. Limitations of these studies are the relatively small number of patients, ranging from 540 to 668, insufficient information on the risk factors of local relapse and a follow-up time up limited to only 10 years.…”

Section: Introductionmentioning

confidence: 99%

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Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years

Sangen

Wiel

Poortmans

et al. 2010

Breast Cancer Res Treat

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(95% CI, 26.7-39.1) to 16.1% (95% CI, 9.1-23.1), (P=.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients ≤40years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual recurrence risk of 1% remains up to 15 years after treatment.Van der Sangen, et al.4

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mentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years

Sangen

Wiel

Poortmans

et al. 2010

Breast Cancer Res Treat

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“…To examine whether outcomes were improved with mrm compared with bct in young women, Coulombe et al 27 retrospectively analyzed the BC Cancer Agency's prospectively assembled Breast Cancer Outcomes Unit database. Age less than 40 years was used to define "young" based on a previous Breast Cancer Outcomes Unit study identifying worse prognosis in that age group than in older patients.…”

Section: Population-based and Retrospective Studies In Young Womenmentioning

confidence: 99%

Comparison of Recurrence and Survival Rates after Breast-Conserving Therapy and Mastectomy in Young Women with Breast Cancer

2013

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Multiple randomized trials have demonstrated that breast-conserving therapy with partial mastectomy and radiotherapy provides survival equivalent to that seen with mastectomy for patients with early-stage breast cancer. Breast-conserving therapy has been associated with better quality of life relative to mastectomy and has become the standard of care for patients with early-stage breast cancer. Young age has been identified as a risk factor for recurrence and death from breast cancer. Some studies have suggested that young women (less than 35 or 40 years of age) have inferior outcomes with breast-conserving therapy, implying that such women may be better served by mastectomy. On review of the available literature, there is no definitive evidence that mastectomy provides a consistent, unequivocal recurrence-free or overall survival benefit over breast-conserving therapy. However, available meta-analyses have not compared outcomes in young women specifically, and such analyses should be performed. In the interim, breast-conserving therapy is not contraindicated in young women (less than 40 years of age) and can be used cautiously; however, such women should be advised of the lack of unequivocal data proving that survival is equivalent to that with mastectomy in their age group.

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“…The increase in local recurrence rate was similar for invasive and intraductal carcinoma [62,63]. A recent analysis of women younger than 50 years comparing BCT with mastectomy showed no significant difference in local, distant recurrence, and overall survival for this selected group [64].…”

Section: Age/menopausal Statusmentioning

confidence: 94%