http://m.medicalxpress.com/news/2016-04-breast-the...

"Now, new research presented at the ESTRO 35 conference today (Saturday) has shown women aged younger than 45 years, who had early stage breast cancer that had not spread to thelymph nodes and who opted for BCT with radiation therapy, had a 13% higher risk of developing a local recurrence of their disease over a 20-year period than women who had a mastectomy and no radiation therapy. Furthermore, local recurrence doubled the risk of the cancer spreading elsewhere in the body (metastasis) and the risk of death was approximately two-thirds higher for BCT patients compared to mastectomy patients.

By contrast, among women aged over 45 there was no link between local recurrence and the risk of metastasis, and there was no difference in the proportion of these women who died after BCT or mastectomy."

Here's a retrospective study from 2014 that looked at women between 20 and 39 with early breast cancer and found 15 year outcomes for those getting breast-conserving surgery plus radiation compared to those getting mastectomy were essentially the same.

Should women younger than 40 years of age with invasive breast cancer have a mastectomy? 15-year outcomes in a population-based cohort.

Cao JQ¹, Truong PT², Olivotto IA³, Olson R⁴, Coulombe G⁵, Keyes M¹, Weir L¹, Gelmon K¹, Bernstein V², Woods R⁶, Speers C⁷, Tyldesley S⁸.

Author information

Abstract

purpose:

Optimal local management for young women with early-stage breast cancer remains controversial. This study examined 15-year outcomes among women younger than 40 years treated with breast-conserving surgery plus whole-breast radiation therapy (BCT) compared with those treated with modified radical mastectomy (MRM).

methods and materials:

Women aged 20 to 39 years with early-stage breast cancer diagnosed between 1989 and 2003 were identified in a population-based database. Primary outcomes of breast cancer-specific survival (BCSS), overall survival (OS) and secondary outcomes of local relapse-free survival (LRFS), locoregional relapse-free survival (LRRFS), and distant relapse-free survival (DRFS) were calculated using Kaplan-Meier methods and compared between BCT and MRM cohorts using log-rank tests. A planned subgroup analysis was performed on patients considered "ideal" for BCT (ie, T1N0, negative margins and no extensive ductal carcinoma in situ) and in whom local therapy may have the largest impact on survival because of low systemic risk.

results:

965 patients were identified; 616 had BCT and 349 had MRM. The median follow-up time was 14.4 years (range, 8.4-23.3 years). Overall, 15-year rates of BCSS (76.0% vs 74.1%, P=.62), OS (74.2% vs 73.0%, P=.75), LRFS (85.4% vs 86.5%, P=.95), LRRFS (82.2% vs 81.6%, P=.61), and DRFS (74.4% vs 71.6%, P=.40) were similar between the BCT and MRM cohorts. In the "ideal" for BCT subgroup, there were 219 BCT and 67 MRM patients with a median follow-up time of 15.5 years. The 15-year BCSS (86.1% vs 82.9%, P=.57), OS (82.6% vs 82.9%, P=.89), LRFS (86.2% vs 84.2%, P=.50), LRRFS (83.1% vs 78.3%, P=.24), and DRFS (84.8% vs 79.1%, P=.17) were similar in the BCT and MRM cohorts.

conclusions:

This population-based analysis with long-term follow-up confirmed that women younger than 40 years treated with BCT had similar 15-year outcomes compared with MRM. Young age alone is not a contraindication to BCT.

http://www.ncbi.nlm.nih.gov/pubmed/25194665