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Young age and outcome for women with early‐stage invasive breast carcinoma
Author(s) -
Zhou Ping,
Recht Abram
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20523
Subject(s) - medicine , mastectomy , contraindication , breast cancer , young adult , ductal carcinoma , stage (stratigraphy) , cancer , surgery , oncology , pathology , paleontology , alternative medicine , biology
BACKGROUND Patients with invasive breast carcinoma who are ages 35–40 years or younger at the time of diagnosis have been found in several studies to have worse prognosis and higher local failure rates after breast‐conserving therapy (BCT) compared with older patients. However, it is uncertain whether specific clinical, pathologic, or treatment factors affect these results, or whether mastectomy yields a better outcome. METHODS Articles addressing how patient age at the time of diagnosis affects treatment outcome were identified through the MEDLINE and CancerLit databases and the reference lists of relevant articles. RESULTS Young age was found to remain an independent risk factor for worse outcome after either BCT or mastectomy. Limited evidence did not demonstrate a superior outcome with mastectomy compared with BCT. Recent studies of BCT still reported young age to be associated with higher local recurrence rates compared with that for older patients, but their interpretation was hampered by inadequate margin assessment for ductal carcinoma in situ. Adjuvant chemotherapy has been found to improve local control rates substantially for young patients after BCT. CONCLUSIONS To the authors' knowledge, there are insufficient data to determine whether young patients have superior long‐term outcome if treated by mastectomy compared with BCT, or whether having truly uninvolved margins abrogates their increased risk of local failure after BCT. When meticulous attention is given to surgical techniques and margin status, it appears that young age at the time of diagnosis need not be a contraindication to BCT. Cancer 2004. © 2004 American Cancer Society.