Posted on September 8th, 2011 by
Two studies presented at the 2011 Breast Cancer Symposium provide evidence that breast-conserving therapy (lumpectomy plus radiation therapy) is as effective as mastectomy for young women with early-stage breast cancer.
Surgery for early-stage breast cancer may consist of mastectomy or lumpectomy. A mastectomy involves removal of the entire breast, whereas a lumpectomy involves removal of the cancer and some surrounding tissue. A lumpectomy is usually followed by radiation therapy in order to reduce the risk of cancer recurrence in or near the breast. The combination of lumpectomy and radiation therapy is referred to as breast-conserving therapy.
Studies have indicated that mastectomy and breast-conserving therapy produce similar long-term survival among women with early-stage breast cancer. Some research has suggested, however, that young women may have a higher risk of breast cancer recurrence than older women after breast-conserving therapy. Concerns about recurrence risk may be contributing to the increasing use of mastectomy among young women.
Two studies that will be presented at the 2011 Breast Cancer Symposium explore whether type of surgery affects outcomes among young women with breast cancer. The first study involved 628 women age 40 and younger who were treated for early-stage breast cancer at Massachusetts General Hospital.
Risk of a local breast cancer recurrence (a recurrence in or near the breast) did not vary significantly by type of surgery. By five years, the risk of a local breast cancer recurrence was 4.6% among women treated with breast-conserving therapy and 8.5% among women treated with mastectomy. By ten years, the risk was 13.3% among women treated with breast-conserving therapy and 10.8% among women treated with mastectomy.
The second study collected information from a large national database about more than 14,000 breast cancer patients under the age of 40.  After accounting for patient and tumor characteristics, breast-conserving therapy and mastectomy produced similar overall survival. Ten-year overall survival was 83.5% among women treated with breast-conserving therapy and 83.6% among women treated with mastectomy.
Together, these studies suggest that mastectomy and breast-conserving therapy produce similar outcomes among young women with early-stage breast cancer. Young women may wish to take this information into account when making decisions about breast cancer treatment.
 Mahmood U, Morris CG, Neuner GA et al. Equivalent survival with breast-conservation therapy or mastectomy in the management of young women with early-stage breast cancer. Paper presented at: 2011 Breast Cancer Symposium; September 8-10, 2011; San Francisco, CA. Abstract 85.
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