Early-Stage Breast Cancer: Treatment Choices for Women With Young Children
Posted: Monday, October 26, 2020
In a recent study published in Cancer, a team of investigators, led by Ya-Chen Tina Shih, PhD, of The University of Texas MD Anderson Cancer Center, Houston, focused on young women with early-stage breast cancer and the relationship between their treatment choices and their children’s ages. Of note, they found that among privately insured women, having young children was strongly associated with the omission of post-lumpectomy radiotherapy and mastectomy. Having more than one young-aged child further amplified these associations.
Using the MarketScan Commercial Claims and Encounters database, the authors identified women between the ages of 20 and 50 who underwent lumpectomy or mastectomy for early-stage breast cancer between 2008 and 2014. A total of 21,052 women were included in the analysis.
Among women with at least 1 child aged up to age 7, the adjusted rate of lumpectomy was 59.9%; approximately 22% of these women did not receive radiotherapy. Compared with women undergoing lumpectomy plus radiotherapy, women with at least 1 child aged up to 7 years or between 7 and 12 years were 25% and 16%, respectively, more likely to undergo lumpectomy alone than women with no children younger than age 18.
The key finding to investigators was that young women who were pressed for time because of child-care responsibilities might perceive mastectomy as the most time-efficient local therapy. However, it should be noted that mastectomy confers no additional clinical benefit over lumpectomy, followed by radiotherapy for early-stage breast cancer. In addition, it has a longer recovery period, with activity restrictions that may affect child-care, particularly among women who opt for postmastectomy reconstruction. Thus, clinicians should be aware that when communicating with patients regarding local therapy options, patients should be fully informed of the short-term and long-term benefits and harms associated with all treatment options.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.