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Lumpectomy, mastectomy provide similar survival outcome for young women with breast cancer

April 07, 2022

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Source / Disclosure

Source:

Pestana C, et al. Young women with breast cancer: does the surgical approach affect overall survival? Presented at: American Society of Breast Surgeons Annual Meeting (hybrid meeting); April 6-10, 2022; Las Vegas.


Disclosure: Pestana does not report any relevant financial disclosures. Please refer to the abstract for relevant financial disclosures of all researchers.


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According to the study results, young women with non-metastatic breast cancer who had breast-conserving surgery experienced OS similar to those who had undergone mastectomy.

Findings presented during the American Society of Breast Surgeons Annual Meeting press briefing point to patients being consulted about outcomes to reduce unnecessary morbidity from surgical procedures, given the increasing use of mastectomy in this age group. .


Black race was associated with a higher risk of death.
Data obtained from Pestana C, et al. Young women with breast cancer: does the surgical approach affect overall survival? Presented at: American Society of Breast Surgeons Annual Meeting (hybrid meeting); April 6-10, 2022; Las Vegas.

In addition, our results emphasize the need for future attention to racial outcome inequalities among young women. Christine pestanaMD, Breast Surgical Oncology Fellow at Atrium Health Levine Cancer Institute said during a presentation.

logic and methods

Pestana said that 1 in 68 women will get breast cancer by age 40, and that these women present with advanced disease more often than their older counterparts.

“Outcome disparities persist between the two groups,” Pestana and colleagues write in the abstract. Mastectomy rates are increasing in younger patients despite a lack of data supporting better survival.

Researchers sought to examine the association between surgical approach and survival among 591 women under the age of 40 (median age, 37 years; 66% White, 25.9% Black) from the Levine Cancer Institute’s Young Women Database. who underwent surgical intervention for non-metastatic. Invasive breast cancer between 2010 and 2019. About two-thirds of the women (64.5%) underwent mastectomy, while 35.5% underwent lumpectomy.

Researchers assessed patient age, race, BMI, disease stage, grade, molecular subtype, presence of lymphovascular space-invasion, extranodal expansion, extent of surgery, presence and timing of chemotherapy and hormonal therapy.

They used univariate and multivariable Cox proportional hazard analysis to determine whether patient, disease, or treatment factors were associated with an increased risk of mortality.

key findings

At a median follow-up of 67 months, 72 women (12%) died. More than half of the women (53.3%) had hormone receptor-positive, HER2-negative disease, 20.8% had hormone receptor-positive/HER2-positive disease, 19.3% had triple-negative disease and 6.6% had HR-negative/HER2-positive Disease.

The researchers saw no difference in OS between women who had mastectomy versus breast-conserving surgery.

Most (85.4%) women with HR-positive/HER2-negative disease received antiestrogen therapy. Among them, the researchers observed a 2.9-fold increased risk for death in women who were not treated with hormone therapy.P = .02).

The results of the univariate analysis showed that Black patients had an increased risk of death across all molecular subtype categories. However, results of multivariate analysis showed an association only among Black women with triple negative breast cancer, who had a 5.7-fold higher mortality (P = .005), even after the researchers accounted for all other risk factors.

Pestana said in a press release, “The results are particularly important because breast cancer is increasingly being diagnosed among young women, despite low rates, and an increasing number of women are opting for mastectomy and even mastectomy instead of breast-conserving surgery. to undergo prophylactic bilateral mastectomy.”

Meaning

According to Pestana, studies like this show that lumpectomy, a much less invasive approach with fewer potential complications and morbidity, is just as effective as removing the entire breast.

He added that the final decision on the surgical approach should be based on shared decision-making.

“Our job is to provide education, encourage engagement and help our patients focus on oncological safety and quality of life throughout their breast cancer journey,” she said during the presentation.

References:

Lumpectomy as effective as mastectomy for young patients with breast cancer (press release). Available at: www.breastsurgeons.org/meeting/2022/releases/young_women. Published on April 6, 2022. Accessed April 6, 2022.
Pestana C, et al. Young women with breast cancer: does the surgical approach affect overall survival? Presented at: American Society of Breast Surgeons Annual Meeting (hybrid meeting); April 6-10, 2022; Las Vegas.

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