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Less Aggressive Breast Cancer Surgery OK

Lumpectomy Safe Option for Young Women With Breast Cancer
WebMD Health News

Dec. 29, 2003 -- Young women may fare just as well with conservative breast cancer treatments that preserve the breast as with more radical treatments, including mastectomy.

A new study shows that women under age 35 who are treated with breast-conserving therapies such as lumpectomy (removal of the breast tumor and some normal tissue surrounding it) have similar survival rates as those treated with radical mastectomy (removal of the breast).

The use of less invasive breast-conserving therapy has become more common in recent years thanks to studies that show the treatment improves the patient's quality of life without increasing the risk of death. But researchers say those studies were done among middle-aged and older women.

Because women under 35 usually have a more aggressive form of breast cancer and higher risk of cancer recurrence than older women diagnosed with the disease, researchers say that many doctors have been reluctant to recommend breast-conserving therapy.

However, these results suggest that a more conservative surgical approach is also appropriate for younger women with breast cancer as long as surgery is followed by chemotherapy, which is the recommended treatment guideline for most women with localized breast cancer.

Lumpectomy OK for Young Women With Breast Cancer

In this study, researchers compared long-term survival rates among premenopausal women with localized breast cancer who were treated with either breast-conserving therapy or radical mastectomy between 1982 and 1998. Some of these women had follow-up chemotherapy and some did not. The results appear in the Feb. 15, 2004, issue of the journal Cancer.

Danish researchers found no increased risk of death within 10 years after diagnosis among women who were treated with breast-conserving therapy compared with those who received radical mastectomy, regardless of their age at diagnosis (under 35 years, 35-39, 40-44, or 45-49).

However, the younger women treated with breast-conserving therapy (BCT) did have a five times higher risk of local cancer recurrence than women aged 40-44. But researchers say that did not affect survival rates.

"Although the high frequency of recurrence among younger patients represents a problem in itself, the current study did not find survival to be significantly different for young women who received BCT compared with those who underwent [radical mastectomy," write researcher Niels Kroman, MD, of the Danish Epidemiology Science Center, and colleagues.

The authors report, however, that the women who received breast-conserving therapy but did not receive chemotherapy tended to die sooner than those who did receive chemotherapy.

In light of these findings, researchers say that chemotherapy should be given to all women under 35 with breast cancer to improve their chances of surviving breast cancer, regardless of surgical treatment approach, as recommended by current international guidelines.

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