title: Is mastectomy superior to breast-conserving treatment for young women?
abstract: OBJECTIVE
  To examine whether modified radical mastectomy (MRM) improves outcomes compared with breast-conserving treatment (BCT) in young women.
  
  
  METHODS
  Women aged 20-49 years, diagnosed with early breast cancer between 1989 and 1998, were identified. Management with BCT or MRM was compared for local (L), locoregional (LR), and distant relapse-free survival (DRFS) and breast cancer-specific survival (BCSS) by age group (20-39 years, 40-49 years). The analysis was repeated for patients considered "ideal" candidates for BCT: tumor size < or =2 cm, pathologically negative axillary nodes, negative margins, and no reported ductal carcinoma in situ.
  
  
  RESULTS
  A total of 1,597 women received BCT, and 801 had MRM. After a median follow-up of 9.0 years, the outcomes (L, LR, BCSS) were worse for the younger age group; however, the outcomes were not statistically different by type of local treatment. For women aged 20-39 years considered "ideal" for BCT, those treated with BCT had slightly lower LRFS compared with those treated with MRM (p = 0.3), but DRFS and BCSS were similar.
  
  
  CONCLUSIONS
  A difference in LRFS at 10 years potentially favored MRM among women aged 20-39 years considered "ideal" BCT candidates but was not statistically significant and did not translate into a noticeable difference in DRFS or BCSS. Our data suggest that young age alone is not a contraindication to BCT.
authors.affiliation: Radiation Therapy Program, British Columbia Cancer Agency, Vancouver, BC, Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Coulombe
authors.forename: Scott
authors.initials: S
authors.lastname: Tyldesley
authors.forename: Caroline
authors.initials: C
authors.lastname: Speers
authors.forename: Chuck
authors.initials: C
authors.lastname: Paltiel
authors.forename: Christina
authors.initials: C
authors.lastname: Aquino-Parsons
authors.forename: Vanessa
authors.initials: V
authors.lastname: Bernstein
authors.forename: Pauline T
authors.initials: PT
authors.lastname: Truong
authors.forename: Mira
authors.initials: M
authors.lastname: Keyes
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Olivotto
mesh_terms: D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016896:Treatment Outcome