A new retrospective study has reported that women under 40 who are treated with breast conserving surgery are less likely to survive than older women who receive similar treatment. The study was designed to evaluate the effect of age at diagnosis on treatment outcome after breast conserving surgery such as lumpectomy or partial mastectomy. The study included 378 women with early stage breast cancer who were divided into two age groups: 108 patients who were under 40 years of age and 270 patients 40 years and older. Variables such as age, tumor characteristics, and use of systemic therapy such as chemotherapy were examined in evaluating likelihood of locoregional relapse-free survival (no recurrence in the breast, chest wall, or lymph nodes), distant metastasis-free survival, and overall survival rates. The women were followed for a median of 94 months.
The eight-year locoregional relapse-free survival rate was found to be 88.1% for younger patients compared to 96.5% for women at least 40. Similarly, distant metastasis-free survival rates were 85.7% and 93.7% and overall survival rates were 89.2% and 95.9% for the younger and older groups, respectively. Young age was the only significant predictor of poor locoregional relapse-free survival using multivariate analysis. Young age and estrogen receptor negative (ER-) tumor had borderline significance in accounting for distant metastasis-free survival. Young age also tended to be associated with inferior overall survival. The authors conclude that age younger than 40 years is associated with inferior locoregional relapse-free survival in early breast cancer patients treated with breast conserving surgery. A trend for inferior distant metastasis-free survival and overall survival was also observed in younger patients. Age at diagnosis should be considered in determining individualized patient management.
Please see our article on how young breast cancer survivors can avoid a recurrence for more information on factors influencing the prognosis of young breast cancer survivors.