Young women with early-stage breast cancer “should be counseled appropriately regarding their treatment options, and should not choose a mastectomy based on the assumption of improved survival,” maintained investigators presenting a retrospective study at the 2011 Breast Cancer Symposium. Their conclusion was based on an analysis of data from 14,764 women treated with either breast-conservation therapy (lumpectomy and radiation) or mastectomy.¹

But what should that counseling involve? Family history and genetic predispositions are major factors to consider in helping women chose the most appropriate treatment,” according to the study’s principal investigator, Usama Mahmood, MD. Depending on the results of genetic testing, particularly whether or not BRCA1 and BRCA2 mutations are identified, “women might choose to undergo prophylactic treatments, such as oophorectomies or mastectomies, or even tamoxifen therapy, and those are important issues to be considered with their physicians,” Dr. Mahmood said. “Unfortunately, in our analysis, we weren’t able to include that information, but it certainly does play a big role,” he added.

Multidisciplinary Evaluation Is Key

“Mammograms play a big role in the diagnosis and follow-up of women with breast cancer, and we are increasingly looking at the utilization of breast MRI. It would seem that especially for younger women with dense breast tissue that decreases the sensitivity of mammograms, it makes sense to use MRI,” he stated.

“In general, it is always good to emphasize the importance of multidisciplinary evaluation,” Dr. Mahmood continued. “For women with breast cancer, this plays even more of a role in these younger women because there is more controversy. It’s best for these women to be evaluated in a multidisciplinary setting where you have not just surgeons and radiation oncologists, but also medical oncologists and pathologists, plastic surgeons, everyone who is involved in breast cancer management.” ■