Abstract
Background
This study evaluated the security of breast-conserving treatment (BCT) in young patients and the effect of regional radiation therapy on young patients with 1–3 positive nodes (N+) treated with BCT.
Methods
In this prospective concurrent controlled study, 164 patients were defined as the BCT group, and regional radiation therapy was delivered to patients with 1–3 N+. Modified radical mastectomies (MRMs) were performed on 224 patients without regional radiation therapy.
Results
The 9-year local recurrence (LR) rate of the BCT was 7 %, compared with 3 % in the MRM group (p = 0.055). The 9-year regional recurrence (RR) rate was 6 % for the BCT group and 12 % for the MRM group (p = 0.048). The distant metastasis (DM)-free and breast cancer-specific survival rates were similar between the two groups. RR was an independent prognostic factor for DM [hazard ratio 3.27; 95 % confidence interval (CI) 1.726–6.208] and breast cancer-specific survival (hazard ratio 5.814; 95 % CI 2.690–12.568), whereas LR was not an independent prognostic factor for DM or breast cancer-specific survival.
Conclusions
Young patients treated with BCT have a higher LR rate than that of MRM. However, LR has no detrimental effect on DM-free and breast cancer-specific survival rates, whereas RR is a strong risk factor of DM and death. Regional radiation therapy for young patients with 1–3 N+ may reduce RR and improve survival rates.
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Acknowledgment
This work was supported by the Nature Science Foundation of China (project 81272895), the Natural Science Foundation of Guangdong in China (project S2012040006681), and the Foundation of the Ministry of Science and Technology of Guangdong Province (project 2011B080701052).
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The authors declare no conflict of interest.
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Zeming Xie and Xi Wang contributed equally to this article.
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Xie, Z., Wang, X., Lin, H. et al. Breast-Conserving Therapy: A Viable Option for Young Women with Early Breast Cancer—Evidence from a Prospective Study. Ann Surg Oncol 21, 2188–2196 (2014). https://doi.org/10.1245/s10434-014-3620-y
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DOI: https://doi.org/10.1245/s10434-014-3620-y