Young Age and Breast Conserving Therapy Are Risk Factors for Loco-Regional Recurrences of Breast Cancer
Breast Cancer and Age
Researchers from Holland have reported that younger age and breast conservation were independent predictors of loco- regional recurrence. The details of this study appeared in the February 2006 issue of the European Journal of Clinical Oncology.
Women with stage I-II breast cancer often undergo lumpectomy followed by radiation therapy rather than mastectomy for small tumors. As a generality there is an increase in loco-regional recurrences in women treated with breast conserving therapy compared to mastectomy but without an adverse affect on survival.
The authors of the current study evaluated the outcomes of over 3,000 women with stage I or II breast cancer. Fifty-five per cent had received breast conservation and 45% had received mastectomy. Follow-up was from 5 to 12 years. They reported that women under the age of 35 years had a hazard ratio for recurrence of 2.80 compared to women over the age of 50 years. The hazard ration for recurrence was 1.72 for women age 35-50 compared to women over the age of 50 years. Women who had breast conserving therapy had a hazard ratio for recurrence of 1.82 compared to mastectomy. Age and breast conserving therapy were independent risk factors for disease recurrence. They also presented data showing a decrease in recurrences by adjuvant chemotherapy.
Comments: These data suggest that young women receiving breast conserving therapy need to be monitored more closely than older women. The fact that women receiving breast conserving therapy have equivalent survivals to women undergoing mastectomy is due to early detection and treatment of loco-regional disease.
Reference: De Bock GH, van der Hage JA, Putter H, et al. Isolated loco-regional recurrence of breast cancer is more common in young patients and following breast conserving therapy: Long-term results of European Organisation for Research and Treatment of Cancer Studies. European Journal of Cancer . 2006;42:351-356.