Introduction/Background Studies have shown that young patients with early-stage breast cancer (BC) are increasingly getting mastectomy instead of breast conserving therapy (BCT) consisting of lumpectomy and radiation. We examined the difference between outcomes in young women (age<40) treated with BCT versus mastectomy. Materials and Methods The Surveillance, Epidemiology, and End Results database was queried for women <40 years of age with stage I–II invasive BC treated with surgery from 1998–2003. Breast cancer specific survival (BCSS) and overall survival (OS) were evaluated by Kaplan-Meier survival analysis and the log–rank test between treatment types. Results Of the 7665 women, 3249 patients received BCT, while 2627 patients had mastectomy and no radiation. When separated by stage (I, IIA, and IIB), with median follow-up of 111 months, the BCT and mastectomy only groups showed no statistically significant differences in the BCSS and OS. Overall, age group 35–39 (66% of total) was associated with better 10-year BCSS (88%) and OS (86.1%) compared to younger patients aged 20–34 (34% of total), who had 10-year BCSS and OS of 84.1% and 82.3%, respectively (P<0.001 for both BCSS and OS). However, when patients of each age group were further subdivided by stages, the BCT group continued to show non-inferior BCSS and OS compared to the mastectomy group in all of the subgroups. Conclusion Our study suggests that while young age may be a poor prognostic factor for BC, there is no evidence that these patients have better outcome with mastectomy over BCT.

Prostate and rectal volumes, but not bladder volumes, on treatment planning CT influenced prostate position on treatment fractions. Daily image-guided adoptive radiotherapy would be required for patients with distended or empty rectum on planning CT to reduce rectal toxicity in the case of empty rectum and to minimize geometric miss of prostate.

This SEER database analysis of patients younger than age 50 and with pT3N0 breast cancer showed that PMRT did not significantly affect CSS at 5 years; however, it implied a trend of benefit for patients younger than 40. The findings that patients with African heritage and negative ER/PR status showing decreased CSS warrant further investigation to determine the role of personalized PMRT in these high-risk cohorts.