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Postmastectomy Radiation and Recurrence Patterns in Breast Cancer Patients Younger Than Age 35 Years: A Population-Based Cohort

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The utility of post mastectomy radiotherapy in very young women is understudied. The objective of this study was to evaluate the use of PMRT in very young women to determine the effect on recurrence and survival.

Methods

All women aged ≤35 years diagnosed with invasive breast cancer from 1994 to 2003 were identified from the Ontario Cancer Registry. Patient, tumour, treatment and outcome data were abstracted from primary chart review. Local or regional recurrence was the primary endpoint with contralateral, distant recurrence/death treated as competing risks. Propensity score methods were incorporated into multivariable Cox proportional hazards models to evaluate the effect of radiation therapy on the time to local/regional, distant recurrence or death.

Results

588 patients were identified during the study period, of which 382 were eligible for analysis. Overall, 182 (48 %) of patients sustained a recurrence after a median follow-up of 2.72 years. The use of PMRT significantly reduced locoregional recurrence (HR 0.54, 95 % CI 0.29–0.996) compared with those who did not receive PMRT. There was no significant effect of PMRT on contralateral, distant recurrences, or death without recurrence (HR 0.98, 95 % CI 0.66–1.47). Of the patients with known node status (N = 451), isolated local recurrence occurred in 5, 2.5, and 8.5 % in patients with N0, N1-3, and N4 positive nodes respectively.

Conclusions

We have found a significant reduction in locoregional recurrence with PMRT but no survival benefit in very young women with breast cancer.

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Authors and Affiliations

  1. Division of Surgery, Foothills Medical Centre, Calgary, AB, Canada

    May Lynn Quan

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Fahima Osman

  3. Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Canada

    David McCready

  4. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

    Kimberley Fernandes & Rinku Sutradhar

  5. Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Lawrence Paszat

  6. Department of Radiation Oncology, Institute for Clinical and Evaluative Sciences, Toronto, ON, Canada

    Lawrence Paszat

Authors
  1. May Lynn Quan
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  2. Fahima Osman
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  3. David McCready
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  4. Kimberley Fernandes
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  5. Rinku Sutradhar
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  6. Lawrence Paszat
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Correspondence to May Lynn Quan.

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Quan, M.L., Osman, F., McCready, D. et al. Postmastectomy Radiation and Recurrence Patterns in Breast Cancer Patients Younger Than Age 35 Years: A Population-Based Cohort. Ann Surg Oncol 21, 395–400 (2014). https://doi.org/10.1245/s10434-013-3319-5

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  • DOI: https://doi.org/10.1245/s10434-013-3319-5

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