title: Effect of breast-conserving therapy versus radical mastectomy on prognosis for young women with breast carcinoma.
abstract: BACKGROUND
  Among middle-aged and older women with early breast carcinoma, breast-conserving therapy (BCT) has been shown to have an effect on survival that is similar to that of modified radical mastectomy (RM). Nonetheless, it remains to be established whether BCT also is the optimal treatment option for early breast carcinoma in young women, because these women generally have more aggressive disease and a higher frequency of local recurrence compared with older women.
  
  
  METHODS
  We investigated a cohort of 9285 premenopausal women with primary breast carcinoma who were age < 50 years at diagnosis. These women were identified from a population-based Danish breast carcinoma database containing detailed information on patient and tumor characteristics, predetermined treatment regimens, and survival.
  
  
  RESULTS
  In total, 7165 patients (77.2%) were treated with RM, and 2120 patients (22.8%) were treated with BCT. We calculated the relative risk of death within the first 10 years after diagnosis according to surgical treatment and age, both before and after adjustment for known prognostic factors. No increased risk of death was observed among women who received BCT compared with women who underwent RM, regardless of age at diagnosis (< 35 years, 35-39 years, 40-44 years, or 45-49 years), despite the increased risk of local recurrence among young women. Restricting the analysis to women with small tumors (size < 2 cm) yielded similar results.
  
  
  CONCLUSIONS
  Despite having a higher rate of local recurrence, young women with breast carcinoma who receive BCT are similar to young women treated with RM in terms of survival.
authors.affiliation: Department of Epidemiology Research, Danish Epidemiology Science Center, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Kroman
authors.forename: Helle
authors.initials: H
authors.lastname: Holtveg
authors.forename: Jan
authors.initials: J
authors.lastname: Wohlfahrt
authors.forename: Maj-Britt
authors.initials: MB
authors.lastname: Jensen
authors.forename: Henning T
authors.initials: HT
authors.lastname: Mouridsen
authors.forename: Mogens
authors.initials: M
authors.lastname: Blichert-Toft
authors.forename: Mads
authors.initials: M
authors.lastname: Melbye
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000601:surgery*; D002277:Carcinoma / Q000601:surgery*; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D006801:Humans; D015409:Mastectomy, Radical; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local; D017697:Premenopause; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D012307:Risk Factors; D016019:Survival Analysis