| Popis: |
Background: Despite significant advances in the treatment and management of breast cancer, young women diagnosed before the age of 40 have worse outcomes as compared to older women with similar cancers. Many posit that this occurrence is related to a propensity to develop more biologically aggressive tumors, while others attribute these differences to the influences of estrogen on this young cohort. Nevertheless, many of the therapeutic measures offered to young women are based on evidence derived from studies of older, post-menopausal women. Objective: To determine whether locoregional management of early-stage invasive breast cancer is associated with long-term survival outcomes in young women during the era of modern multimodal therapies. Methods: A systematic review of retrospective cohort studies published within the last 10 years. Results: Although younger women who undergo breast-conserving therapy (BCT) have higher rates of local recurrence (LR), this review indicates that either there is a slight survival advantage after BCT compared to mastectomy (M), or that there is no survival difference based on these interventions. Conclusion: Presently, there is insufficient evidence to determine whether younger women should continue to undergo more aggressive local treatment approaches, emphasizing the need for prospective controlled trials to generate more reliable information on the magnitude of survival benefits of BCT and M in young women. |
