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Lumpectomy, Mastectomy Result in Similar Outcomes in Younger Patients with Breast Cancer

Choice of surgery was not associated with overall survival differentiations in younger patients with breast cancer, according to study results presented at The American Society of Breast Surgeons Annual Meeting. 

Christine Pestana, MD, and colleagues accessed the Young Women’s Database and identified 591 patients treated for nonmetastatic invasive breast cancer at Atrium Health, Levine Cancer Institute in Charlotte, between 2010 and 2019. The cohort had a median age of 37 years (interquartile range, 34-39) and a median time to follow-up of 67 months (interquartile range, 41-98). 

The most common molecular subtype was HR+/HER2– disease (n = 315), followed by HR+/HER2+ (n = 123), triple-negative (n = 114), and HR–/HER2+ (n = 39). Among patients with HR+/HER2– disease, 85.4% received antiestrogen therapy. 

In total, 72 patients had died at the time of reporting, representing 12% of the cohort. The researchers evaluated numerous variables for association with OS, including race, age, body-mass index, disease stage and grade, type of surgery (lumpectomy vs mastectomy), presence and timing of chemotherapy, and receipt of hormone therapy.  

A multivariable analysis revealed that only the absence of hormone therapy led to an increased risk of death compared to its receipt (P = .02). 

“On univariate analysis, black race was associated with an increased risk of death in all molecular subtype categories. However, on multivariate analysis, this only held true in the triple-negative group, where black race was associated with a 5.7 times increased risk of death (P = .005) even after accounting for all other risk factors,” Pestana and colleagues wrote. 

Surgical choice did not correlate with OS in any molecular subgroup, and the researchers observed no significant associations for patients with HR+/HER2+ or HR–/HER2+ disease. 

Disclosures: MD /alert could not confirm financial disclosures at the time of reporting. 

Reference: 
https://www.breastsurgeons.org/meeting/2022/releases/young_women

By Cameron Kelsall, MD /alert Contributor 

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