Despite Breast-Conserving Surgery Eligibility, Nearly 50% of Women Chose Mastectomy

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A patients choice to undergo mastectomy may be driven by factors other than disease progression alone.
A patients choice to undergo mastectomy may be driven by factors other than disease progression alone.
The following article features coverage from the San Antonio Breast Cancer Symposium (SABCS) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Although use of neoadjuvant systemic therapy increased the number of young women with breast cancer eligible for breast-conserving surgery (BCS), nearly half still chose to undergo mastectomy despite response, according to the Young Women's Breast Cancer Study presented at the 2018 San Antonio Breast Cancer Symposium in Texas.1

According to the researchers, “these data highlight that surgical decision making among young women with breast cancer is often driven by factors beyond extent of disease and clinical response to therapy.”

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The study enrolled 1302 women with breast cancer aged 40 or younger. The researchers were looking at response to neoadjuvant therapy, patient eligibility for BCS before and after neoadjuvant therapy, and chosen surgical treatment. 

Of the enrolled women, 62% had unilateral stage I to III breast cancer and 40% received neoadjuvant therapy. The median age of these women was 36 years. 

Prior to neoadjuvant therapy, 27% were eligible for BCS, 15% were considered to be borderline, and 53% were ineligible. Among the patients who were ineligible or borderline, 38% became eligible for BCS after undergoing neoadjuvant therapy. Four patients who were eligible prior to therapy become ineligible after treatment. 

Among patients eligible for BCS after therapy, about half (49%) attempted BCS and 93% were successful. The other half (51%) of women chose to undergo mastectomy. Among the reasons given for undergoing mastectomy the most common was patient preference (46%), followed by BRCAorTP53mutation (37%), family history (4%), or unknown reasons (13%). 

Overall, 24% of patients achieved pathologic complete response. Of those with complete response, 64% underwent mastectomy, but only 44% of the mastectomies were performed for anatomic indications. 

Read more of Cancer Therapy Advisor's coverage of the SABCS 2018 meeting by visiting the conference page.

Reference

  1. Kim HJ, Dominici L, Rosenberg S, et al. Surgical treatment after neoadjuvant systemic therapy in young women with breast cancer: results from a prospective cohort study. Presented at: 2018 San Antonio Breast Cancer Symposium; Dec. 4-8, 2018; San Antonio, TX. Abstract GS6-01.

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