Researchers looked at trends in the surgical treatment of young women with invasive cancer using information from the National Breast Cancer Audit (NBCA). The rate of breast conserving treatment for women aged 40 years or younger in Australia and New Zealand stayed at around 53% between 1999 and 2006. This suggests that the use of breast conserving treatment in younger patients has stabilised, although more research is needed to check that this is the best level of care for patients.
Patients were less likely to have breast conserving treatment than mastectomy if the cancer was:
- multifocal (i.e. more than one cancer in the breast)
- >30 mm in diameter
- centrally located (i.e. behind the nipple)
- high grade (i.e. cancer cells were more likely to spread)
- also present in a lymph node
- EIC positive (had an extensive intraductal component, that is, an extensive area of ductal carcinoma in situ beyond the invasive cancer).
Studies have shown that the presence of these factors means the cancer is more likely to recur at the site if the tumour is removed through breast conserving surgery. By providing mastectomy in those cases, surgeons contributing to the NBCA are making decisions based on the best available evidence for managing breast cancer in young women.