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William J. Gradishar, MD, FACP, FASCO


Does Extent of Surgery Impact Overall Survival for Younger Patients With Breast Cancer?

By: Victoria Kuhr, BA
Posted: Tuesday, April 26, 2022

Christine Pestana, MD, of Atrium Health, Levine Cancer Institute, Winston-Salem, North Carolina, and colleagues reported that overall survival did not seem to differ based upon whether young patients with non-metastatic invasive breast cancer opted for lumpectomy or mastectomy. These study findings were presented at the 2022 Annual Meeting of the American Society of Breast Surgeons (ASBrS) in Las Vegas.

“Studies specifically focusing on these patients would likely yield important information that may help physicians better understand, counsel, and treat these patients and help women in their decision-making,” said Dr. Pestana in an ASBrS press release.

The study conducted a retrospective chart review of women included in the Young Women’s Database at a single institution. Patients younger than age 40 with non-metastatic invasive breast cancer who underwent surgical intervention between 2010 and 2019 were included in the study.

The study enrolled 591 patients. Of these patients, 12% (72) died. The median patient age was 37. The median time to follow-up was 67 months. These patients had molecular subtypes including hormone receptor–positive/HER2-negative (HR+/HER2–) in 315 patients, HR+/HER2-positive (HER2+) in 123 patients, triple-negative in 114 patients, and HR–/HER2+ in 39 patients. Several factors were tested for an association with overall survival, including age, race, body mass index, disease stage, grade, presence of lymphovascular space invasion, extranodal extension, extent of surgery, presence and timing of chemotherapy, and presence of hormonal therapy.

Of the HR+/HER2– group, 85.4% of patients took antiestrogen therapy. Only an absence of hormone therapy appeared to be significant, with a 2.9 times increased risk of death for patients who did not take hormone therapy compared with those who did. African American ethnicity was associated with a 5.7 times increased risk of death in those with triple-negative disease. There were no significant associations reported for the HR+/HER2+ or HR–/HER2+ groups. The use of mastectomy versus breast conservation did not impact overall survival in any of the molecular subtypes.

Disclosure: For full disclosure of study authors, visit

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