Breast Cancer Research and Treatment

, Volume 101, Issue 1, pp 51–57

Factors Affecting Outcome for Young Women with Early Stage Invasive Breast Cancer Treated with Breast-conserving Therapy

Authors

    • Joint Center for Radiation TherapyHarvard Medical School
    • BROF
  • Shiva Gautam
    • Department of BiostatisticsBeth Israel Deaconess Medical Center
  • Abram Recht
    • Department of Radiation OncologyBeth Israel Deaconess Medical Center, and Harvard Medical School
Clinical Trial

DOI: 10.1007/s10549-006-9268-y

Cite this article as:
Zhou, P., Gautam, S. & Recht, A. Breast Cancer Res Treat (2007) 101: 51. doi:10.1007/s10549-006-9268-y

Abstract

Background

Young women have worse outcome following breast-conserving therapy (BCT) than do older patients in many studies. We examined how clinical, pathological, and treatment factors affect these results.

Methods

Between 1993 and 1999, 130 patients age 40 years or younger with stage I or II breast cancer were treated with BCT. The median radiation dose to the tumor bed was 61 Gy; 80% of patients received chemotherapy; and 29% of 72 patients with estrogen-receptor positive tumors received tamoxifen. Median follow-up was 93 months.

Results

Fifteen patients (12%) developed an ipsilateral breast tumor recurrence (IBTR), with or without other simultaneous failure sites. The Kaplan-Meier 5- and 8-year actuarial rates were 8% and 14%, respectively. The 74 patients with grade 3 tumors had a higher IBTR rate (8-year actuarial rate, 18%) than the 54 patients with grade 1–2 lesions (7%) (P = 0.09). Six patients developed contralateral breast cancers, and 17 developed distant metastases (DM). The 8-year actuarial rates for freedom-from-DM, relapse-free survival, and overall survival were 85%, 72% and 96%, respectively.

Conclusion

This represents one of the largest series of young women treated with BCT, using an approach similar to current practice. The IBTR rate was substantially lower than in many past studies, but still higher than would be expected for older women. This appeared largely due to the increased rate of IBTR in patients with grade 3 tumors. If this observation is confirmed, further analysis of this subgroup may lead to ways of reducing the risk of IBTR.

Keywords

Breast cancerYoung ageRadiation therapyLocal recurrenceBreast-conserving therapyHistologic grade

Abbreviations

EIC

Extensive intraductal component

LVI

Lymphovascular invasion

ER

Estrogen receptor protein

RT

Radiation therapy

Copyright information

© Springer Science+Business Media B.V. 2006