The safety of breast‐conserving therapy in patients with breast cancer aged ≤40 years

• Published in: Cancer Vol. 109; no. 10; pp. 1957 - 1964
• Main Authors: van der Leest, Marloes, Evers, Lisette, van der Sangen, Maurice J. C., Poortmans, Philip M., van de Poll‐Franse, Lonneke V., Vulto, Ans J., Nieuwenhuijzen, Grard A. P., Brenninkmeijer, Stefan J., Creemers, Geert‐Jan, Voogd, Adri C.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.05.2007; Wiley-Liss
• Subjects: Adult; Age Factors; Biological and medical sciences; breast carcinoma; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; breast‐conservation; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; local recurrence; Mammary gland diseases; Mastectomy, Segmental; Medical sciences; Neoplasm Recurrence, Local; radiotherapy; Risk Factors; Survival Rate; Tumors; Human; Relapse; Conservation; Breast cancer; Malignant tumor; Radiotherapy; Mammary gland diseases; Breast carcinoma; Cancerology; Treatment; local recurrence; Mammary gland; breast-conservation
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.22639

BACKGROUND. The objectives of this study were to study the probability of local control after breast‐conserving therapy (BCT) in a large population of patients with early‐stage breast cancer aged ≤40 years and to determine which factors had prognostic value. METHODS. All patients (n = 758) aged ≤40 years with clinical stage I or II breast cancer who underwent BCT in general hospitals in the southern part of the Netherlands between 1988 and 2002 were selected for the current analysis. BCT included local excision of the tumor followed by irradiation of the breast. Of 758 patients, 329 patients (43%) received adjuvant systemic treatment, and 36 patients (5%) underwent a microscopically incomplete excision. The median follow‐up was 8.5 years. RESULTS. During follow‐up, 95 patients developed a local recurrence without evidence of distant disease at the time the recurrence was diagnosed. Contralateral breast cancer was diagnosed in 59 patients. The 5‐ and 10‐year actuarial local recurrence rates were 9.0% (95% confidence interval [95% CI], 6.6–11.4%) and 17.9% (95% CI, 14.1–21.7%), respectively. In a multivariate analysis, adjuvant systemic treatment reduced the risk of local recurrence (hazards ratio [HR], 0.47; 95% CI, 0.28–0.78) and contralateral breast cancer (HR, 0.46; 95% CI, 0.24–0.87) by >50%. CONCLUSIONS. The risk of local recurrence in young patients who underwent BCT was reduced strongly by using adjuvant systemic treatment. This finding may provide an argument if favor of advising the use of systemic treatment for all patients aged ≤40 years who undergo BCT. Cancer 2007. © 2007 American Cancer Society. In a cohort of 758 patients with breast cancer aged ≤40 years who underwent breast‐conserving therapy between 1988 and 2002, the 10‐year actuarial risks of local recurrence and contralateral breast cancer were 17.9% and 9.6%, respectively. These risks were reduced by >50% in patients who received adjuvant systemic treatment.