title: The effect of surgery type on survival and recurrence in very young women with breast cancer.
abstract: BACKGROUND
  The impact of surgical treatment on outcomes in breast cacner in very young women remains unclear. We sought to determine the effect of surgery type on risk of recurrence and survival in a population-based cohort.
  
  
  METHODS
  All women diagnosed with breast cancer aged ≤35 (1994-2003) were identified from the Ontario Cancer Registry. Patient, tumor, and treatment variables, including primary surgery, recurrences, and death were abstracted from chart review. Cox regression models were fit to determine the effect of surgery type on recurrence and overall survival.
  
  
  RESULTS
  We identified 1,381 patients with 11-year median follow-up of which 793 (57%) had BCS. Of the remaining mastectomy patients, 52% had postmastectomy radiation. Overall, 41% of patients sustained a recurrence of any type and 31% died. Controlling for known confounders, there was no association between type of surgery and death from any cause (HR = 0.98, 95% CI = 0.78, 1.25) or first recurrence (HR = 0.93, 95% CI = 0.75, 1.14). Distant recurrence was most common (13% in BCS; 25.3% in mastectomy) with local recurrence 12.4% after BCS and 7.5% after mastectomy.
  
  
  CONCLUSIONS
  In this cohort of very young women who were selected for treatment with BCS and mastectomy, we found similar oncologic outcomes. J. Surg. Oncol. 2017;115:122-130. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Foothills Medical Centre, University of Calgary, Calgary, Canada.|Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: May Lynn
authors.initials: ML
authors.lastname: Quan
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.|Sunnybrook Health Sciences Centre, Toronto, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
authors.forename: Lawrence Frank
authors.initials: LF
authors.lastname: Paszat
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Fernandes
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
authors.forename: Rinku
authors.initials: R
authors.lastname: Sutradhar
authors.affiliation: University Health Network-Princess Margaret Hospital, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: David R
authors.initials: DR
authors.lastname: McCready
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.|Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Eileen
authors.initials: E
authors.lastname: Rakovitch
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: Ellen
authors.initials: E
authors.lastname: Warner
authors.affiliation: Sunnybrook Health Sciences Centre, Toronto, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, Canada.
authors.forename: Frances C
authors.initials: FC
authors.lastname: Wright
authors.affiliation: Juravinski Cancer Centre, Hamilton, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hodgson
authors.affiliation: London Health Sciences Centre, Victoria Hospital, London, Canada.
authors.forename: Muriel
authors.initials: M
authors.lastname: Brackstone
authors.affiliation: Institute for Clinical Evaluative Sciences, Toronto, Canada.|Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.|Department of Surgery, University of Toronto, Toronto, Canada.|Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Baxter
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008408:Mastectomy / Q000401:mortality*; D015412:Mastectomy, Segmental / Q000401:mortality*; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: breast cancer; surgery type; survival; very young women