title: Family history and treatment outcome in young women after breast-conserving surgery and radiation therapy for early-stage breast cancer.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of breast-conserving therapy for young women with a family history (FH) suggestive of inherited breast cancer susceptibility.
  
  
  METHODS
  A total of 201 patients aged 36 or younger at diagnosis treated with breast-conserving surgery and radiation therapy (> or = 60 Gy) for early-stage breast cancer were categorized by FH. FH was considered positive in 29 patients who, at the time of diagnosis, had a mother or sister previously diagnosed with breast cancer before age 50 or ovarian cancer at any age. Clinical, pathologic, and demographic variables; sites of first failure; disease-free survival; and overall survival (OS) were compared between FH-positive and -negative groups. Median follow-up time was 11 years.
  
  
  RESULTS
  Patient and tumor features were similar between those with and without an FH. Regression analysis of sites of first failure at 5 years demonstrated a risk ratio (RR) of 5.7 for opposite breast cancer for FH-positive patients. Rates of local, regional, and distant failure and disease-free survival or OS did not differ between FH-positive and -negative patients. Age at diagnosis and Ashkenazi heritage were not significantly predictors of patterns of failure.
  
  
  CONCLUSIONS
  Breast-conserving surgery combined with radiation therapy is not associated with a higher rate of local recurrence, distant failure, or second (non-breast) cancers in young women with an FH suggestive of inherited breast cancer susceptibility compared with young women without an FH. However, their increased risk of opposite breast cancer should be taken into account when considering breast conservation as a treatment option.
authors.affiliation: Joint Center for Radiation Therapy, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
authors.forename: E
authors.initials: E
authors.lastname: Chabner
authors.forename: A
authors.initials: A
authors.lastname: Nixon
authors.forename: R
authors.initials: R
authors.lastname: Gelman
authors.forename: S
authors.initials: S
authors.lastname: Hetelekidis
authors.forename: A
authors.initials: A
authors.lastname: Recht
authors.forename: B
authors.initials: B
authors.lastname: Bornstein
authors.forename: J
authors.initials: J
authors.lastname: Connolly
authors.forename: S
authors.initials: S
authors.lastname: Schnitt
authors.forename: B
authors.initials: B
authors.lastname: Silver
authors.forename: J
authors.initials: J
authors.lastname: Manola
authors.forename: J
authors.initials: J
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Garber
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D016609:Neoplasms, Second Primary / Q000235:genetics; D010051:Ovarian Neoplasms / Q000235:genetics; D015996:Survival Rate; D016896:Treatment Outcome