Surgical Management of Young Women with High-Risk Breast Cancer Receiving Neoadjuvant Systemic Therapy on the I-SPY2 Trial.
J Tseng, K Dimitroff, C A M Sauder et al.
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In 30 seconds
This secondary analysis of a multicenter clinical trial compared surgical management and outcomes by age among patients with high-risk, stage II–III breast cancer who received neoadjuvant systemic therapy. Of 1,737 patients, 698 (40.2%) were aged ≤ 45 years. Breast-conserving surgery was less common in younger than older patients (36.8% vs 48.5%, p < 0.001). Among patients aged ≤ 45 years, surgery type was not associated with overall survival or locoregional recurrence-free interval. The authors conclude that greater surgical extent was not associated with better outcomes in younger women.
Key findings
- Breast-conserving surgery was less common in patients aged ≤ 45 years than in those aged > 45 years (36.8% vs 48.5%, p < 0.001).
- Among patients aged ≤ 45 years, surgery type was not associated with overall survival or locoregional recurrence-free interval.
- Patient and tumor characteristics and residual cancer burden distribution did not differ significantly between age groups.
Why it matters
The findings address whether younger age and the higher use of mastectomy in younger women correspond to better outcomes after neoadjuvant therapy. In this trial population, more extensive breast surgery was not associated with improved survival or locoregional recurrence outcomes among younger patients, informing discussion of surgical options without treating age alone as an indication for mastectomy.
What to keep in mind
This was a secondary analysis, and the reported associations do not establish that surgery type causes or does not cause differences in outcomes.