title: Comparison of recurrence and survival rates after breast-conserving therapy and mastectomy in young women with breast cancer.
abstract: 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.
authors: BC Cancer Agency, Vancouver Centre, Vancouver, BC.
authors: J Q
authors: JQ
authors: Cao
authors: R A
authors: RA
authors: Olson
authors: S K
authors: SK
authors: Tyldesley
keywords: Breast cancer; breast-conserving therapy; mastectomy; recurrence; survival; young women