Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years
To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT....
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| Veröffentlicht in: | Breast cancer research and treatment 2011-05, Vol.127 (1), p.207-215 |
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| creator | van der Sangen, Maurice J. C. van de Wiel, Fenneke M. M. Poortmans, Philip M. P. Tjan-Heijnen, Vivianne C. G. Nieuwenhuijzen, Grard A. P. Roumen, Rudi M. H. Ernst, Miranda F. Tutein Nolthenius-Puylaert, M. Cathelijne B. J. E. Voogd, Adri C. |
| description | To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4–6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5–8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3–10.5), 18.4% (95% CI 15.0–21.8) and 28.2% (95% CI 23.0–33.4), respectively (
P
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| doi_str_mv | 10.1007/s10549-010-1110-x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_00594467v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A355939458</galeid><sourcerecordid>A355939458</sourcerecordid><originalsourceid>FETCH-LOGICAL-c490x-23fedf3199a1cc8d5d37ba9734cce91a2d66e5982911edfca1174d214092f63b3</originalsourceid><addsrcrecordid>eNp1kl9u1DAQxiMEoqVwAF6QBQKERIod55-f0KoCirQSL_BseZ3JbirH3trOdvcI3IIHToLERTgJk2bbUgSKFMszv28-jz1J8pjRY0Zp9SYwWuQipYymjOFveyc5ZEXF0ypj1d3kkLKySsualgfJgxDOKKWiouJ-cpDRinLB68Pk58wDWXhQIRLtbAC_UbFzlijbkB6joKPrdwTOB2UMrm2LkW4DpLMkroBE1MYebCSuJTs32CW5cLgnF11cEVAeRVf1ldXg35K5s8s0gu-JhzCYGEapImu3HsylebpQARo8z8r5y7rsdV4wssYkGgWilpj99fV7Tn9826FFeJjca5UJ8Gi_HiVf3r_7fHKazj99-Hgym6c6F3SbZryFpuVMCMW0rpui4dVCiYrnWoNgKmvKEgpRZ4IxBLVirMqbjOVUZG3JF_woeTXVXSkj177rld9Jpzp5OpvLMUZpIfK8rDYM2ZcTu_bufIAQZd8FDcYoC24Isi5ZIRgvSiSf_kWeucFbbGSE0D0rKULPJmipDMjOti56pceScsaLQnCRFzVSx_-g8Gug7_B9oe0wfkvw4g_BCpSJq-DMMD5DuA2yCdTeheChve6fUTlOo5ymUdJxj9Mot6h5sm9sWPTQXCuuxg-B53tABa1M63FCunDD4cULznPksokLmLJL8Dc39H_332W3-NY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>861140260</pqid></control><display><type>article</type><title>Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>van der Sangen, Maurice J. C. ; van de Wiel, Fenneke M. M. ; Poortmans, Philip M. P. ; Tjan-Heijnen, Vivianne C. G. ; Nieuwenhuijzen, Grard A. P. ; Roumen, Rudi M. H. ; Ernst, Miranda F. ; Tutein Nolthenius-Puylaert, M. Cathelijne B. J. E. ; Voogd, Adri C.</creator><creatorcontrib>van der Sangen, Maurice J. C. ; van de Wiel, Fenneke M. M. ; Poortmans, Philip M. P. ; Tjan-Heijnen, Vivianne C. G. ; Nieuwenhuijzen, Grard A. P. ; Roumen, Rudi M. H. ; Ernst, Miranda F. ; Tutein Nolthenius-Puylaert, M. Cathelijne B. J. E. ; Voogd, Adri C.</creatorcontrib><description>To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4–6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5–8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3–10.5), 18.4% (95% CI 15.0–21.8) and 28.2% (95% CI 23.0–33.4), respectively (
P
< 0.0001). Adjuvant systemic therapy following BCT reduced the 15-year local relapse risk from 32.9% (95% CI 26.7–39.1) to 16.1% (95% CI 9.1–23.1), (
P
= 0.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients ≤40 years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual risk of local relapse of 1% remains up to 15 years after treatment.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-010-1110-x</identifier><identifier>PMID: 20703938</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Adjuvant treatment ; Adult ; Age Factors ; Analysis ; Biological and medical sciences ; Breast cancer ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Cancer ; Cancer research ; Cancer therapies ; Care and treatment ; Cohort Studies ; Combined Modality Therapy ; Comparative studies ; Epidemiology ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Lumpectomy ; Mammary gland diseases ; Mastectomy - standards ; Mastectomy, Segmental - standards ; Medical prognosis ; Medical sciences ; Medicine ; Medicine & Public Health ; Neoplasm Staging ; Oncology ; Recurrence ; Surgical techniques ; Survival Analysis ; Tumors ; Women ; Young Adult ; Young adults</subject><ispartof>Breast cancer research and treatment, 2011-05, Vol.127 (1), p.207-215</ispartof><rights>Springer Science+Business Media, LLC. 2010</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2011 Springer</rights><rights>Springer Science+Business Media, LLC. 2011</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490x-23fedf3199a1cc8d5d37ba9734cce91a2d66e5982911edfca1174d214092f63b3</citedby><cites>FETCH-LOGICAL-c490x-23fedf3199a1cc8d5d37ba9734cce91a2d66e5982911edfca1174d214092f63b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-010-1110-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-010-1110-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24099334$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20703938$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00594467$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>van der Sangen, Maurice J. C.</creatorcontrib><creatorcontrib>van de Wiel, Fenneke M. M.</creatorcontrib><creatorcontrib>Poortmans, Philip M. P.</creatorcontrib><creatorcontrib>Tjan-Heijnen, Vivianne C. G.</creatorcontrib><creatorcontrib>Nieuwenhuijzen, Grard A. P.</creatorcontrib><creatorcontrib>Roumen, Rudi M. H.</creatorcontrib><creatorcontrib>Ernst, Miranda F.</creatorcontrib><creatorcontrib>Tutein Nolthenius-Puylaert, M. Cathelijne B. J. E.</creatorcontrib><creatorcontrib>Voogd, Adri C.</creatorcontrib><title>Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4–6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5–8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3–10.5), 18.4% (95% CI 15.0–21.8) and 28.2% (95% CI 23.0–33.4), respectively (
P
< 0.0001). Adjuvant systemic therapy following BCT reduced the 15-year local relapse risk from 32.9% (95% CI 26.7–39.1) to 16.1% (95% CI 9.1–23.1), (
P
= 0.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients ≤40 years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual risk of local relapse of 1% remains up to 15 years after treatment.</description><subject>Adjuvant treatment</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Analysis</subject><subject>Biological and medical sciences</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Cancer</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Comparative studies</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Lumpectomy</subject><subject>Mammary gland diseases</subject><subject>Mastectomy - standards</subject><subject>Mastectomy, Segmental - standards</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Recurrence</subject><subject>Surgical techniques</subject><subject>Survival Analysis</subject><subject>Tumors</subject><subject>Women</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kl9u1DAQxiMEoqVwAF6QBQKERIod55-f0KoCirQSL_BseZ3JbirH3trOdvcI3IIHToLERTgJk2bbUgSKFMszv28-jz1J8pjRY0Zp9SYwWuQipYymjOFveyc5ZEXF0ypj1d3kkLKySsualgfJgxDOKKWiouJ-cpDRinLB68Pk58wDWXhQIRLtbAC_UbFzlijbkB6joKPrdwTOB2UMrm2LkW4DpLMkroBE1MYebCSuJTs32CW5cLgnF11cEVAeRVf1ldXg35K5s8s0gu-JhzCYGEapImu3HsylebpQARo8z8r5y7rsdV4wssYkGgWilpj99fV7Tn9826FFeJjca5UJ8Gi_HiVf3r_7fHKazj99-Hgym6c6F3SbZryFpuVMCMW0rpui4dVCiYrnWoNgKmvKEgpRZ4IxBLVirMqbjOVUZG3JF_woeTXVXSkj177rld9Jpzp5OpvLMUZpIfK8rDYM2ZcTu_bufIAQZd8FDcYoC24Isi5ZIRgvSiSf_kWeucFbbGSE0D0rKULPJmipDMjOti56pceScsaLQnCRFzVSx_-g8Gug7_B9oe0wfkvw4g_BCpSJq-DMMD5DuA2yCdTeheChve6fUTlOo5ymUdJxj9Mot6h5sm9sWPTQXCuuxg-B53tABa1M63FCunDD4cULznPksokLmLJL8Dc39H_332W3-NY</recordid><startdate>201105</startdate><enddate>201105</enddate><creator>van der Sangen, Maurice J. 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Long-term results of a population-based cohort of 1,451 patients aged ≤40 years</title><author>van der Sangen, Maurice J. C. ; van de Wiel, Fenneke M. M. ; Poortmans, Philip M. P. ; Tjan-Heijnen, Vivianne C. G. ; Nieuwenhuijzen, Grard A. P. ; Roumen, Rudi M. H. ; Ernst, Miranda F. ; Tutein Nolthenius-Puylaert, M. Cathelijne B. J. 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Obstetrics</topic><topic>Humans</topic><topic>Lumpectomy</topic><topic>Mammary gland diseases</topic><topic>Mastectomy - standards</topic><topic>Mastectomy, Segmental - standards</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Recurrence</topic><topic>Surgical techniques</topic><topic>Survival Analysis</topic><topic>Tumors</topic><topic>Women</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van der Sangen, Maurice J. C.</creatorcontrib><creatorcontrib>van de Wiel, Fenneke M. M.</creatorcontrib><creatorcontrib>Poortmans, Philip M. P.</creatorcontrib><creatorcontrib>Tjan-Heijnen, Vivianne C. G.</creatorcontrib><creatorcontrib>Nieuwenhuijzen, Grard A. P.</creatorcontrib><creatorcontrib>Roumen, Rudi M. 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C.</au><au>van de Wiel, Fenneke M. M.</au><au>Poortmans, Philip M. P.</au><au>Tjan-Heijnen, Vivianne C. G.</au><au>Nieuwenhuijzen, Grard A. P.</au><au>Roumen, Rudi M. H.</au><au>Ernst, Miranda F.</au><au>Tutein Nolthenius-Puylaert, M. Cathelijne B. J. E.</au><au>Voogd, Adri C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2011-05</date><risdate>2011</risdate><volume>127</volume><issue>1</issue><spage>207</spage><epage>215</epage><pages>207-215</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract>To compare the effectiveness of breast-conserving therapy (BCT) and mastectomy, all women aged ≤40 years, treated for early-stage breast cancer in the southern part of the Netherlands between 1988 and 2005, were identified. A total of 562 patients underwent mastectomy and 889 patients received BCT. During follow-up, 23 patients treated with mastectomy and 135 patients treated with BCT developed a local relapse without previous or simultaneous evidence of distant disease. The local relapse risk for patients treated with mastectomy was 4.4% (95% confidence interval (CI) 2.4–6.4) at 5 years and reached a plateau after 6 years at 6.0% (95% CI 3.5–8.5). After BCT, the 5-, 10- and 15-year risks were 8.3% (95% CI 6.3–10.5), 18.4% (95% CI 15.0–21.8) and 28.2% (95% CI 23.0–33.4), respectively (
P
< 0.0001). Adjuvant systemic therapy following BCT reduced the 15-year local relapse risk from 32.9% (95% CI 26.7–39.1) to 16.1% (95% CI 9.1–23.1), (
P
= 0.0007). In conclusion, local tumor control in young patients with early-stage breast cancer is worse after BCT than after mastectomy. Adjuvant systemic therapy significantly improves local control following BCT and also for that reason it should be considered for most patients ≤40 years. Long-term follow-up is highly recommended for young patients after BCT, because even with systemic treatment an annual risk of local relapse of 1% remains up to 15 years after treatment.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>20703938</pmid><doi>10.1007/s10549-010-1110-x</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Breast cancer research and treatment, 2011-05, Vol.127 (1), p.207-215 |
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| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adjuvant treatment Adult Age Factors Analysis Biological and medical sciences Breast cancer Breast Neoplasms - pathology Breast Neoplasms - surgery Cancer Cancer research Cancer therapies Care and treatment Cohort Studies Combined Modality Therapy Comparative studies Epidemiology Female Gynecology. Andrology. Obstetrics Humans Lumpectomy Mammary gland diseases Mastectomy - standards Mastectomy, Segmental - standards Medical prognosis Medical sciences Medicine Medicine & Public Health Neoplasm Staging Oncology Recurrence Surgical techniques Survival Analysis Tumors Women Young Adult Young adults |
| title | Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years |
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