Surgical Management of Breast Cancer in Young Women

Young women with breast cancer have poorer prognosis, higher risk of locoregional recurrence and greater likelihood of genetic predisposition if compared with the older counterpart. However, the worse prognosis of many young patients cannot be mitigated by a more aggressive local treatment, as more extensive surgery does not result in improved survival. After historical trials emphasizing the very high risk of locoregional recurrence after breast-conserving surgery in young women, modern studies have reported improved outcomes after breast conservation compared to mastectomy, through a tailored synergic approach of surgery plus radiotherapy and systemic therapy. As a matter of fact, the European Society of Breast Cancer Specialists (EUSOMA) working group confirmed that conservative surgery is the first option, whenever suitable, for young breast cancer patients too in the most recent international consensus guidelines for breast cancer in young women (BCY3). The care of young women with breast cancer should always be tailored on the single patient and her specific issues related to genetic risk, fertility preservation, sexuality, activities of daily living, social life, pregnancy and lactation which could affect in a way surgical decision and timing. For this reason, young breast cancer patients deserve a “special” attention and a multidisciplinary approach in order to choose the best surgical treatment.