Evaluating outcomes after a local recurrence following breast conserving surgery in young breast cancer patients

This study evaluated survival rates after a local recurrence (return of the cancer close to the place of the initial cancer) in young breast cancer patients treated with breast conserving surgery.

Young patients with early stage breast cancer are usually treated with breast conserving surgery or BCS (removal of the cancerous lump only or lumpectomy), with or without radiotherapy. This type of surgery aims to preserve as much of the breast tissue and shape as possible. It has proven to have the same effect on survival as a mastectomy (removal of the whole breast with the cancer), but without the psychological trauma of this invasive surgery. However, breast cancer patients younger than 40 treated with BCS are thought to have a higher risk of developing a local recurrence compared to older patients. This study evaluated survival rates and risk factors for the cancer spreading in young breast cancer patients who had a local recurrence after a BCS.

This study included 124 women with breast cancer less than 40 years old at the time of diagnosis who were treated with BCS and radiotherapy. All women were followed up for an average period of 10 years after the treatment and developed a local recurrence during follow up. Of these, 121 patients received a salvage mastectomy (a treatment after return of the cancer following a previous therapy). 53 patients had a recurrence within 5 years after the first treatment, 41 between 5 and 10 years and 30 developed a recurrence more than 10 years after the initial BCS. Of the 124 participants, 87% had a recurrence near the site of the initial cancer.

Results showed that patients whose recurrences occurred in less than 5 years following BCS, those who reported symptoms or had signs at breast examination and those whose cancers were larger than 2 cm at recurrence had a higher risk of developing a distant recurrence (cancer spread in other organs or tissues of the body). 5 and 10 years following the salvage treatment, the overall survival (defined as the percentage of patients who survived for a certain period of time) was 90% and 73% respectively and the distant recurrence-free survival (defined as the percentage of patients who did not develop a recurrence in other organs and tissues of the body) was 73% and 61% respectively. In addition, 10 years after the salvage treatment, 95% of the participants survived without another local recurrence or further progression of the cancer.

In summary, local recurrences in young breast cancer patients treated with BCS found because of symptoms reported by the patients or by signs at breast examination can predict a higher risk of the cancer spreading. However, early detection by regular breast imaging can improve treatment outcomes in these patients.

This was a retrospective study (it looked at patients who were treated in the past, rather than following them throughout their treatment). Retrospective studies are known to provide weak statistical information. Also, the group of participants was small and information regarding their type of breast cancer was not available in all patients. Type of cancer can also be a factor that influences survival and must be taken into consideration.

Visit your doctor for regular ultrasound (a test that uses sound waves to create images of tissues in the body) of the breast or mammography (x-ray of the breast).