The effect of surgery type on survival and recurrence in very young women with breast cancer |
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Authors: | May Lynn Quan MD Lawrence Frank Paszat MD Kimberly A. Fernandes Rinku Sutradhar David R. McCready MD Eileen Rakovitch MD Ellen Warner MD Frances C. Wright MD Nicole Hodgson MD Muriel Brackstone MD Nancy N. Baxter MD |
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Affiliation: | 1. Foothills Medical Centre, University of Calgary, Calgary, Canada;2. Institute for Clinical Evaluative Sciences, Toronto, Canada;3. Sunnybrook Health Sciences Centre, Toronto, Canada;4. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada;5. University Health Network‐Princess Margaret Hospital, Toronto, Canada;6. Department of Surgery, University of Toronto, Toronto, Canada;7. Juravinski Cancer Centre, Hamilton, Canada;8. London Health Sciences Centre, Victoria Hospital, London, Canada;9. Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada |
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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. |
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Keywords: | breast cancer very young women surgery type survival |
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