Women younger than 45 years who opt for breast conserving therapy (BCT) over mastectomy may have a higher risk of developing a local recurrence over a 20-year period, according to research presented at European Society for Therapeutic Radiotherapy and Oncology (ESTRO) 35 (April 29-May 3, 2016; Turin, Italy).
For the study, researchers from Aarhus University Hospital in Denmark followed 1076 women diagnosed with low-risk breast cancer for a period of 20 years. A total of 364 women received BCT, and 712 had a mastectomy. None received any systemic therapies.
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After 20 years, patients who received BCT were more than twice as likely to experience local recurrences as those who received mastectomy (66 women [18%] vs 55 women [6.7%]). Among women who received mastectomies, age also seemed to be a contributing factor, with recurrences occurring in the first 5 years for older women, and in the first 10 years for younger women. Conversely, in the BCT group, patients of all ages had recurrence of their disease throughout the 20-year period.
After further analysis, researchers determined that, among patients older than 45 years, there was no significant difference in 20-year mortality between BCT and mastectomy. However, in patients younger than 45 years, local recurrence was associated with distant metastasis, and patients treated with BCT had an increased risk of death during the 20-year study period.
Unlike prior studies analyzing the long-term outcomes of BCT and mastectomy, the findings presented at ESTRO were unique due to both the size of the study and its large proportion of younger participants.
"Data concerning the long-term effect of BCT versus mastectomy among young patients is very limited,” said study lead author Tinne Laurberg, MD. “Our study of young breast cancer patients was unbiased, all patients were lymph-node negative, they received only BCT or mastectomy and we had complete 20-year data on local recurrence and overall survival."
She concluded by saying that future guidelines for the treatment of young patients with lymph-node-negative breast cancer should be refined to include the potential negative impact BCT has on survival.
