FAMILY HISTORY AND TREATMENT OUTCOME IN YOUNG-WOMEN AFTER BREAST-CONSERVING SURGERY AND RADIATION-THERAPY FOR EARLY-STAGE BREAST-CANCER

Purpose: To evaluate the safety and efficacy of breast-conserving ther apy for young women with a family history (FH) suggestive of inherited breast cancer susceptibility. Materials and Methods: A total of 201 p atients aged 36 or younger at diagnosis treated with breast-conserving surgery and radiation therapy(greater than or equal to 60 Gy) for ear ly-stage breast cancer were categorized by FH. FH was considered posit ive in 29 patients who, at the time of diagnosis, had a mother or sist er previously diagnosed with breast cancer before age 50 or ovarian ca ncer at any age. Clinical, pathologic, and demographic variables; site s of first failure; disease-free survival; and overall survival (OS) w ere compared between FH-positive and -negative groups. Median follow-u p time was 11 years. Results: Patient and tumor features were similar between those with and without an FH. Regression analysis of sites of first failure at 5 years demonstrated a risk ratio (RR) of 5.7 for opp osite breast cancer for FH-positive patients. Rates of local, regional , and distant failure and disease-free survival or OS did not differ b etween FH-positive and -negative patients. Age at diagnosis and Ashken azi heritage were not significant predictors of patterns of failure. C onclusion: Breast-conserving surgery combined with radiation therapy i s not associated with a higher rate of local recurrence, distant failu re, or second (nonbreast) cancers in young women with an FH suggestive of inherited breast cancer susceptibility compared with young women w ithout an FH. However, their increased risk of opposite breast cancer should be taken into account when considering breast conservation as a treatment option.