Local Treatment Options For Young Patients With Early-stage Breast Cancer

Objective:Compared with older patients,young age breast cancer(YABC)have a poorer prognosis and a higher risk of recurrence.Age is an independent risk factor for local recurrence of breast cancer.Surgery is the most important local treatment for YWBC,and currently,the evidence regarding the effect of surgical decisions on cancer recurrence and survival remains controversial.This study reviewed and compared the effects of different surgical methods on disease-free survival(DFS)and overall survival(OS)in YABC,and explored whether the first choice of breast-conserving treatment is safe for YABC.Methods:A retrospective study was performed on young patients with breast cancer aged ≤35 years old who were admitted to the First Hospital of Jilin University from January 2011 to December 2021.They were divided into two groups according to surgical protocols:(1)breast-conserving group and(2)mastectomy group.For survival analysis,a Kaplan-Meier method was used to draw the survival curve and log-rank test was used to compare the differences.Univariate analysis with P < 0.1 was included in the multivariate analysis,Univariate and multivariate Cox proportional risk model was used to explore the survival factors in YABC.P < 0.05 was considered statistically significant.Results:A total of 179 patients were included in this study.The T stages of the two groups were either T1 or T2,and the histological types of the two groups were mainly invasive ductal carcinoma.The histological grades were mainly grade 2,the TNM stages were mostly stage I-II,and the molecular types were mainly luminal type.There was no significant difference in clinicopathologic features between the two groups.A total of 14 cases experienced recurrence and metastasis during the follow-up,including four cases(5.6%)in the breast-conserving group and ten cases(9.3%)in the mastectomy group.A total of three deaths occurred,including one patient in the breast-conserving group(1.4%)and two patients in the mastectomy group(1.9%).Kaplan-Meier analysis showed that 5-year DFS was 86.5% in the mastectomy group and89.2% in the breast conservation group,with no statistical significance(HR=0.654,95%CI:0.205-2.092,P=0.474).In addition,there was no statistical difference in OS between the two groups(HR=0.885,95%CI:0.081-9.809,P=0.924),and 5-year OS in the breast-conserving and mastectomy groups were96.3% and 96.4%,respectively.COX proportional hazard regression model showed tumor T stage(HR=9.538,95%CI:1.165-78.086,P=0.036)and lymph node metastasis(HR=4.252,95%CI:1.215-14.887,P=0.024)were independent risk factors for DFS in YABC.Conclusions:Breast-conserving surgery or mastectomy does not affect DFS and OS in young patients with breast cancer.Therefore,breast-conserving surgery is safe as the first choice for early breast cancer in young women.