In the US, one in 196 women is diagnosed with breast cancer under the age of 40 years. There are currently four main molecular subtypes of invasive breast cancer, or groupings of breast cancers that share characteristics, each of which affects individuals differently. Prior studies have shown that after surgery for breast cancer, patients under 40 years may experience a potential increased risk of isolated locoregional recurrence (LRR), whereby cancer returns to its primary site or in nearby lymph nodes. It is well recognized, however, that modern treatment, including optimal systemic and local therapy, can significantly reduce the risk of LRR.
Dr. Shoshana Rosenberg, associate professor of population health sciences, and colleagues conducted a study published in JAMA Surgery, which evaluated whether risks for isolated LRR in young women with breast cancer vary by molecular subtype. These women, diagnosed at 40 years or younger between 2006 and 2016, were treated with modern systemic therapy for stage I through III breast cancer.
Among over 1100 women evaluated, researchers observed overall low rates of isolated LRR in long-term follow-up, with no significant differences in LRR by tumor subtype. There were also no significant differences in LRR based on type of locoregional treatment. While younger age has historically been associated with higher risk for local recurrence, rates of LRR were comparable with rates observed in contemporary studies inclusive of women of all ages. It is likely that modern treatment practices contributed to the lower rates of recurrence in this study.
“These data are reassuring and can be helpful to both patients and providers to support decision-making around breast cancer surgery,” said Dr. Rosenberg. She explained that as more young women are being diagnosed with breast cancer, many of whom will experience an extended period of survivorship, longer-term follow-up is essential for understanding future LRR risk in these patients.
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