Mastectomy No Better Than Breast Conservation for Young Women wiht Breast Cancer, New Study Finds
BOSTON, MA – Mastectomy does not offer a significant advantage over breast-conserving surgery followed by radiation therapy for young women diagnosed with breast cancer, according to findings from the US young Women’s Breast Cancer Study published in Deutsches Ärzteblatt. The research challenges conventional thinking regarding the need for more aggressive surgical approaches in this patient population.
The study analyzed data from 1,153 patients who underwent surgery between October 2006 adn June 2016. Age demographics within the cohort revealed 12.8% were under 30, 28% were between 31 and 35, and 59.2% were between 36 and 40 years old. Breast-conserving surgery was utilized in 30% of cases, with 98% of those patients subsequently receiving radiation. The remaining patients opted for mastectomy, frequently enough bilateral due to heightened genetic risk concerns common in younger women. Radiation therapy followed mastectomy in 54% of these patients.
Researchers, led by Prof. Laura Dominici MD from the Dana-Farber Cancer Institute in Boston, reported a locoregional recurrence rate of 6.7% after breast-conserving surgery, observed over an average of 10.1 years. Following mastectomy without radiotherapy, the recurrence rate was 6.5%, while mastectomy with radiation yielded a rate of 2.4%.
“This means that breast-conserving surgery with radiotherapy could be an alternative to mastectomy without radiotherapy,” Dominici stated. The improved outcomes associated with mastectomy and radiotherapy were potentially linked to its preferential use in patients identified as having a higher risk of distant metastases – a group excluded from the analysis due to the clinical irrelevance of locoregional recurrences in the presence of distant disease.
Dominici attributes the lower recurrence rates observed in the Young Women’s Study (YWS) cohort compared to the POSH cohort to advancements in treatment protocols. Specifically, 28.1% of YWS patients received neoadjuvant chemotherapy, compared to 15.5% in the POSH cohort. Moreover, 92.2% versus 12.5% of patients received ERBB2-targeted therapy when appropriate.
comparing the current findings to an analysis of the Saarland cancer registry published in BMC Cancer, Dominici noted a locoregional recurrence rate of 8% across all age groups diagnosed between 1999 and 2009. Dominici concluded that, with comprehensive therapy, younger patients do not demonstrate an elevated risk of locoregional recurrence.
DOI: 10.3238/Persgyn.2025.10.17.08
