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      Oncologic safety of breast-conserving surgery in breast cancer patients under the age of 35

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      https://www.riss.kr/link?id=A106110602

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      다국어 초록 (Multilingual Abstract)

      Purpose: Breast-conserving surgery (BCS) shows no difference in survival rates compared with total mastectomy. So, BCS is considered standard breast surgery with modified radical mastectomy. But in patients who received BCS, there is a risk of local recurrence in their long term follow up periods. Especially, BCS of young age is controversial regarding oncologic safety because of local recurrence. In this study, we struggle to confirm the oncologic safety of BCS compared with total mastectomy under the age of 35 in South Korea.
      Methods: All patients who underwent surgery for breast cancer were 5,366 at Severance Hospital, Yonsei University Health System, from January 1981 to April 2008. Of them, patients younger than 35 years old were 547. We excluded patients who received chemotherapy before surgery and included only stage 1 and 2 patients who identified through the pathology after surgery. Finally, we got 367 patients; total mastectomy was performed in 245 and BCS, in 122. We compared clinicopathological characteristics and oncologic outcomes between two groups using SPSS program.
      Results: In patients received BCS, a local recurrence rate was 7.7% at 5 years and up to 20.3% at 10 years. In patients received total mastectomy, a local recurrence rate was 1.9% over 10 years (P<0.001). However, there was no difference in 5-year and 10-year overall survival rates between two groups (P=0.689). Adjuvant chemotherapy decreased local recurrence rate in BCS patients (P=0.019).
      Conclusion: So, we concluded that BCS under the age of 35 has oncologic safety with undergoing chemotherapy.
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      Purpose: Breast-conserving surgery (BCS) shows no difference in survival rates compared with total mastectomy. So, BCS is considered standard breast surgery with modified radical mastectomy. But in patients who received BCS, there is a risk of local r...

      Purpose: Breast-conserving surgery (BCS) shows no difference in survival rates compared with total mastectomy. So, BCS is considered standard breast surgery with modified radical mastectomy. But in patients who received BCS, there is a risk of local recurrence in their long term follow up periods. Especially, BCS of young age is controversial regarding oncologic safety because of local recurrence. In this study, we struggle to confirm the oncologic safety of BCS compared with total mastectomy under the age of 35 in South Korea.
      Methods: All patients who underwent surgery for breast cancer were 5,366 at Severance Hospital, Yonsei University Health System, from January 1981 to April 2008. Of them, patients younger than 35 years old were 547. We excluded patients who received chemotherapy before surgery and included only stage 1 and 2 patients who identified through the pathology after surgery. Finally, we got 367 patients; total mastectomy was performed in 245 and BCS, in 122. We compared clinicopathological characteristics and oncologic outcomes between two groups using SPSS program.
      Results: In patients received BCS, a local recurrence rate was 7.7% at 5 years and up to 20.3% at 10 years. In patients received total mastectomy, a local recurrence rate was 1.9% over 10 years (P<0.001). However, there was no difference in 5-year and 10-year overall survival rates between two groups (P=0.689). Adjuvant chemotherapy decreased local recurrence rate in BCS patients (P=0.019).
      Conclusion: So, we concluded that BCS under the age of 35 has oncologic safety with undergoing chemotherapy.

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      참고문헌 (Reference)

      1 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

      2 Veronesi U, "Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer" 347 : 1227-1232, 2002

      3 DiBiase SJ, "The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma" 82 : 2212-2220, 1998

      4 Han W, "Relationship between age at diagnosis and outcome of premenopausal breast cancer: age less than 35 years is a reasonable cut-off for defining young age-onset breast cancer" 119 : 193-200, 2010

      5 Arndt V, "Quality of life over 5years in women with breast cancer after breast-conserving therapy versus mastectomy: a population-based study" 134 : 1311-1318, 2008

      6 Ohsumi S, "Quality of life of breast cancer patients and types of surgery for breast cancer:current status and unresolved issues" 14 : 66-73, 2007

      7 Engel J, "Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study" 10 : 223-231, 2004

      8 Mirza NQ, "Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy" 9 : 256-265, 2002

      9 Park CC, "Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence" 18 : 1668-1675, 2000

      10 van Dongen JA, "Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial" 92 : 1143-1150, 2000

      1 Fisher B, "Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer" 347 : 1233-1241, 2002

      2 Veronesi U, "Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer" 347 : 1227-1232, 2002

      3 DiBiase SJ, "The number of positive margins influences the outcome of women treated with breast preservation for early stage breast carcinoma" 82 : 2212-2220, 1998

      4 Han W, "Relationship between age at diagnosis and outcome of premenopausal breast cancer: age less than 35 years is a reasonable cut-off for defining young age-onset breast cancer" 119 : 193-200, 2010

      5 Arndt V, "Quality of life over 5years in women with breast cancer after breast-conserving therapy versus mastectomy: a population-based study" 134 : 1311-1318, 2008

      6 Ohsumi S, "Quality of life of breast cancer patients and types of surgery for breast cancer:current status and unresolved issues" 14 : 66-73, 2007

      7 Engel J, "Quality of life following breast-conserving therapy or mastectomy: results of a 5-year prospective study" 10 : 223-231, 2004

      8 Mirza NQ, "Predictors of locoregional recurrence among patients with early-stage breast cancer treated with breast-conserving therapy" 9 : 256-265, 2002

      9 Park CC, "Outcome at 8 years after breast-conserving surgery and radiation therapy for invasive breast cancer: influence of margin status and systemic therapy on local recurrence" 18 : 1668-1675, 2000

      10 van Dongen JA, "Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial" 92 : 1143-1150, 2000

      11 Touboul E, "Local recurrences and distant metastases after breast-conserving surgery and radiation therapy for early breast cancer" 43 : 25-38, 1999

      12 Elkhuizen PH, "Local recurrence after breast-conserving therapy for invasive breast cancer: high incidence in young patients and association with poor survival" 40 : 859-867, 1998

      13 Coulombe G, "Is mastectomy superior to breast-conserving treatment for young women?" 67 : 1282-1290, 2007

      14 Clarke M, "Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials" 366 : 2087-2106, 2005

      15 Kroman N, "Effect of breast-conserving therapy versus radical mastectomy on prognosis for young women with breast carcinoma" 100 : 688-693, 2004

      16 Vicini FA, "Does local recurrence affect the rate of distant metastases and survival in patients with early-stage breast carcinoma treated with breast-conserving therapy?" 97 : 910-919, 2003

      17 Voogd AC, "Differences in risk factors for local and distant recurrence after breast-conserving therapy or mastectomy for stage I and II breast cancer: pooled results of two large European randomized trials" 19 : 1688-1697, 2001

      18 Blichert-Toft M, "Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. Danish Breast Cancer Cooperative Group" 19-25, 1992

      19 van der Sangen MJ, "Are breast conservation and mastectomy equally effective in the treatment of young women with early breast cancer? Long-term results of a population-based cohort of 1,451 patients aged ≤40 years" 127 : 207-215, 2011

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