Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: Mastectomy rates are increasing in young patients despite few data supporting improved outcomes.We investigated the association between surgical approach and survival in young patients with breast cancer. Materials and Methods:Retrospective review identified women ≤40 years old with operable, non-metastatic invasive breast cancer treated between 2010-2019.Cox proportional hazard analyses, stratified by hormone receptor and human epidermal growth factor receptor 2 (HER2) status, identified factors associated with increased risk of recurrence and death.Results: Of 588 patients, 65% underwent mastectomy and 35% breast conserving surgery (BCS).Median follow-up was 5.9 years.Overall recurrence and mortality rates were 15% and 12%, respectively.On multivariable analysis, black race [hazard ratio (HR), 2.14 (1.26-3.61),p = 0.005], lymphovascular space invasion (LVSI) [HR, 1.98 (1.17-3.36),p = 0.01], and extranodal extension [HR, 2.12 (1.09-4.12),p = 0.03] were associated with increased risk of death.Stage III disease [HR, 2.06 (1.05-4.03),p = 0.04] and LVSI [HR, 2.18 (1.43-3.32),p<0.001] were associated with increased risk of recurrence.Increasing age decreased the risk of death [HR, 0.94 (0.88-0.99), p = 0.02] and recurrence [HR, 0.95 (0.90-0.99), p = 0.02].Mastectomy versus BCS did not impact recurrence [HR,, p = 0.51] or overall survival (OS) [HR, 0.86 (0.46-1.58), p = 0.62] in the entire cohort.BCS was associated with increased risk of recurrence in the hormone receptor-/HER2+ subtype [HR, 9.06 (1.03-80.00),p = 0.047] but did not affect survival.Conclusion: OS does not differ by surgery type in young patients with breast cancer.Future research should focus on racial disparities in breast cancer care.
Language: English
Subfield: Cancer Research
Domain: Life Sciences
Open Access status: diamond
OpenAlex ID: W7140167177