In the Modern Treatment Era, Is Breast Conservation Equivalent to Mastectomy in Women Younger Than 40 Years of Age? A Multi-Institution Study
| Autor: | David K. Gaffney, Kristine E. Kokeny, David Ly, Matthew M. Poppe, Jonathan Frandsen, George Cannon, Cindy B. Matsen, Gita Suneja, Melissa Wright |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty Time Factors Antineoplastic Agents Hormonal medicine.medical_treatment Antineoplastic Agents Breast Neoplasms Kaplan-Meier Estimate Disease-Free Survival Breast cancer Utah Internal medicine Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging Registries Mastectomy Survival analysis Neoplasm Staging Proportional Hazards Models Analysis of Variance Radiation Breast conservation business.industry Proportional hazards model Carcinoma Ductal Breast Age Factors Cancer medicine.disease Survival Analysis Surgery Radiation therapy Carcinoma Lobular Female Radiotherapy Adjuvant Neoplasm Recurrence Local business Organ Sparing Treatments Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 93:1096-1103 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2015.08.044 |
| Popis: | Purpose Mastectomy is often recommended for women ≤40 years of age with breast cancer, as young women were under-represented in the landmark trials comparing breast conservation therapy (BCT) to mastectomy. We hypothesized that, in the modern treatment era, BCT and mastectomy result in equivalent local control rates in young women. Methods and Materials Breast cancer cases arising between 1975 and 2013 in women ≤40 years old were collected from the tumor registries of 2 large healthcare systems in Utah. Kaplan-Meier estimates and Cox proportional hazards models were used to analyze freedom from locoregional recurrence (FFLR), overall survival (OS), and relapse-free survival (RFS). Results This analysis identified 853 BCT candidates. A comparison of BCT to mastectomy after 2000 showed FFLR, RFS, and OS were all similar. Rate for FFLR at 10 years was 94.9% versus 92.1% for BCT and mastectomy, respectively ( P =.57). For women whose cancer was diagnosed after 2000, who received BCT, FFLR and RFS rates were improved compared to those whose cancer was diagnosed prior to 2000 ( P P =.46) rates were similar. Among those who underwent mastectomy, FFLR, OS, and RFS were significantly improved ( P Conclusions FFLR rates for young women, ≤40 years of age, have significantly improved for BCT and mastectomy over time. If patients were treated after 2000, BCT appears to be safe and equivalent to mastectomy at 10 years in terms of FFLR, OS, and RFS. |
| Databáze: | OpenAIRE |
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