Does Breast Conservation Therapy in Young Women with Breast Cancer Adversely Affect Local Disease Control and Survival Rate? The M. D. Anderson Cancer Center Experience

Abstract: Historically, it was thought that young women with breast cancer had a poor prognosis and a high local disease recurrence rate after breast-conservation therapy. To determine the effect of breast-conservation therapy, the outcomes of young women with breast cancer who were treated at a single institution were retrospectively reviewed.
Between 1978 and 1993, 219 women ≤35 years of age with breast cancer were treated at the University of Texas M. D. Anderson Cancer Center and met the following criteria: no evidence of distant metastasis at the time of diagnosis, no prior treatment, and no concurrent cancers. The variables analyzed included demographics, type of surgery, TNM stage, use of adjuvant therapy, locoregional disease recurrences, distant metastases, and vital status. The median length of follow-up among surviving patients was 7.9 years (range, 1–17 years). Univariate analyses were performed using the log-rank test. Multivariate analyses were performed using the Cox proportional hazards model.
Seventy-nine patients underwent breast-conservation therapy (BCT) and 140 patients underwent modified radical mastectomy (MRM). Locoregional disease recurrences were identified in 27 cases: 12 in the BCT group and 15 in the MRM group. When patients were matched stage for stage, the type of local treatment did not correlate with the loco-regional recurrence rate (p = 0.236) or the disease-specific survival rate (p = 0.915). The five-year disease-specific survival rate was 84.2%. In the multivariate analysis, only TNM stage correlated with locoregional recurrence rate (p = 0.019) and disease-specific survival rate (p = 0.002).
This study shows no significant difference in locoregional recurrence rates or disease-specific survival rates in young women with breast cancer treated with BCT versus MRM.