A new study has reported that local recurrence is more common after breast conserving surgery (lumpectomy) than after mastectomy in young patients with early-stage breast cancer. The study, which was designed to compare the effectiveness of lumpectomy and mastectomy among women up to 40 years of age, included women diagnosed between 1988 and 2005 in the Netherlands. A total of 889 patients had a lumpectomy and 562 underwent mastectomy. During the follow-up period, 135 women who had been treated with lumpectomy and 23 patients treated with mastectomy developed a local recurrence (in the breast, chest wall, or lymph nodes).
The cumulative local relapse risk after lumpectomy was 8.3% at five years, 18.4% at 10 years, and 28.2% at 15 years. On the other hand, the local relapse risk for women treated with mastectomy was 4.4% at five years and reached a plateau after six years at 6.0%. chemotherapy following lumpectomy reduced the 15-year local relapse risk to 16.1%. The authors comment that since chemotherapy significantly improves local control following lumpectomy, it should be considered for most patients under 40 years. In addition, long-term follow-up is highly recommended for young patients after lumpectomy, because an annual risk of local relapse of 1% remains up to 15 years after treatment even with systemic treatment.