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Lumpectomy on par with mastectomy for some young women

American Society of Breast Surgeons annual meeting
Reuters Health - 13/04/2022 - Young women with non-metastatic breast cancer have similar survival whether treated with mastectomy or lumpectomy, despite tumors that are often more aggressive and found at a later stage compared with older women, new research suggests.

"The results are particularly significant because younger women are increasingly being diagnosed with breast cancer, despite low rates overall, and a growing number are undergoing mastectomy and even prophylactic bilateral mastectomy rather than breast conserving surgery," Dr. Christine Pestana says in a news release from the American Society of Breast Surgeons annual meeting where the results were presented.

"Studies like this show that lumpectomy, a far less aggressive approach with fewer potential complications and morbidity, is equally as effective as removing an entire breast," adds Dr. Pestana, with Atrium Health, Levine Cancer Institute, Winston Salem, North Carolina.

The researchers took a look back at 591 young women diagnosed with localized breast cancer and treated surgically between 2010 and 2018 at their center.

The median age for the cohort was 37 years and time to follow up after surgery was 67 months. A total of 72 women (12%) died during follow up.

More than half of the women (53.3%) had HR+/HER2- breast cancer, 20.8% had HR+/HER2+, 19.3% had triple negative disease, and 6.6% were HR-/HER2+.

"The use of mastectomy versus breast conservation did not impact overall survival in any of the molecular subtypes," the researchers report in their conference abstract.

Additionally, survival was similar across HR and HER2 subtypes. However, within the HR+/HER2- group, failure to take antiestrogen therapy was associated with a higher risk of dying. The vast majority of women with HR+/HER2- disease did take antiestrogen therapy (85.4%).

Black patients with triple negative cancers also had higher mortality. No other factors examined were associated with lower survival.

Dr. Pestana notes that younger women have historically been excluded from breast cancer treatment trials.

"A decision on breast cancer surgical treatment has many implications, and these women will live with them the rest of their lives," she says in the news release, noting that younger women with breast cancer may constitute a unique and under-represented population.

"Studies specifically focusing on these patients would likely yield important information that may help physicians better understand, counsel and treat these patients and help women in their decision-making," she notes.

"Breast cancer is a particularly difficult disease for younger women. The medical system should prioritize empowering cancer patients and those at risk with research, guidance and information focusing on their specific age group," Dr. Pestana says.

"Patients may benefit from consulting with several doctors to take advantage of multiple perspectives. Peace-of-mind is an important consideration. Ultimately, patients must be comfortable with their decision, and their doctors should support an informed choice," she advises.

SOURCE: https://bit.ly/3xtPo3E American Society of Breast Surgeons annual meeting, held April 6-10, 2022.

By Reuters Staff

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