Comparing breast conserving therapy and mastectomy in young breast cancer patients

This article compares breast conserving therapy and mastectomy as primary treatments for breast cancer in young patients. 

In young patients with localized (confined) breast cancer, surgical treatment which leaves as much breast tissue as possible is often preferred. This type of surgery is called breast conserving surgery and is generally followed by radiotherapy to destroy any remaining cells. This is known as breast conserving therapy (BCT). An alternative therapy is a mastectomy, the surgical removal of all the breast tissue in the cancer-affected breast. Previous studies have shown that patients treated with BCT have a higher risk of cancer recurrence (return of the cancer) compared to patients treated with mastectomy. This study aimed to test whether BCT also results in a higher risk of the cancer spreading or lower survival in young breast cancer patients.

536 women under the age of 40 diagnosed with localized breast cancer were included in this trial. Of these, 323 patients were treated with BCT and 213 underwent a mastectomy. After an average follow up period of 9 years, the authors of the study found that patients treated with BCT were three times more likely to have a recurrence in the same breast compared to those treated with a mastectomy. However, the 10-year risk of the cancer spreading beyond the breast or dying was higher in patients treated with mastectomy (30.6%) compared to patients treated with BCT (26.3%). 

Overall, although BCT was linked to a higher risk of the cancer returning locally, this did not result in an increased risk of the cancer spreading and lower survival in young patients with localized breast cancer.

This was a retrospective study (it looks back at patients that have been treated in the past rather than following them throughout their treatment and determining their outcomes), which may be considered to have a weaker statistical power.