title: Breast-conserving therapy: a viable option for young women with early breast cancer--evidence from a prospective study.
abstract: BACKGROUND
  This study evaluated the security of breast-conserving treatment (BCT) in young patients and the effect of regional radiation therapy on young patients with 1-3 positive nodes (N+) treated with BCT.
  
  
  METHODS
  In this prospective concurrent controlled study, 164 patients were defined as the BCT group, and regional radiation therapy was delivered to patients with 1-3 N+. Modified radical mastectomies (MRMs) were performed on 224 patients without regional radiation therapy.
  
  
  RESULTS
  The 9-year local recurrence (LR) rate of the BCT was 7 %, compared with 3 % in the MRM group (p = 0.055). The 9-year regional recurrence (RR) rate was 6 % for the BCT group and 12 % for the MRM group (p = 0.048). The distant metastasis (DM)-free and breast cancer-specific survival rates were similar between the two groups. RR was an independent prognostic factor for DM [hazard ratio 3.27; 95 % confidence interval (CI) 1.726-6.208] and breast cancer-specific survival (hazard ratio 5.814; 95 % CI 2.690-12.568), whereas LR was not an independent prognostic factor for DM or breast cancer-specific survival.
  
  
  CONCLUSIONS
  Young patients treated with BCT have a higher LR rate than that of MRM. However, LR has no detrimental effect on DM-free and breast cancer-specific survival rates, whereas RR is a strong risk factor of DM and death. Regional radiation therapy for young patients with 1-3 N+ may reduce RR and improve survival rates.
authors.affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
authors.forename: Zeming
authors.initials: Z
authors.lastname: Xie
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.forename: Huanxin
authors.initials: H
authors.lastname: Lin
authors.forename: Weidong
authors.initials: W
authors.lastname: Wei
authors.forename: Peng
authors.initials: P
authors.lastname: Liu
authors.forename: Xiangsheng
authors.initials: X
authors.lastname: Xiao
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Xie
authors.forename: Xunhang
authors.initials: X
authors.lastname: Guan
authors.forename: Mingtian
authors.initials: M
authors.lastname: Yang
authors.forename: Jun
authors.initials: J
authors.lastname: Tang
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate