It has long been controversial whether breast cancer of the younger women is more aggressive than that of older women and remains unclear whether the dismal outcome seen in the younger age group is a refiection of more advanced disease at the time of diagnosis or whether it is due to a difference in the underlying tumor biology. To investigate the outcome of primary breast cancers treated with breast conservation surgery according to the patient's age, we undertook this study.

One hundred and eighty-five patients with breast carcinoma, that underwent breast conservation surgery at the Severance Hospital, Yonsei University College of Medicine, during the period between July 1988 and December 1996, were divided into two groups on the basis of age 35 (patient group: age 35 or younger, and control group: over 35 years of age). Tumor stage by the American Joint of Committee on Cancer (AJCC) classification, histologic grade, adjuvant therapy, and the incidence of local or systemic recurrences were analyzed. Finally 10-year loco-regional recurrence free, distant relapse free (DRFS) and overall survival (OS) were estimates determined by Kaplan-Meier analysis.

Among 185 patients, 42 women (22.7%) were included in the patient young group and the other 143 in the control group. There were no significant differences between the two groups in terms of the distribution of T stages, N stages, histologic subtypes, hormonal receptor expressions, and mean follow-up duration. The younger group had higher 10-year local recurrence (14.3%) and systemic recurrence (28.6%) rates than the control group (4.2% and 12.6%), respectively (p<0,05). The younger group also had a significantly worse 10-year overall survival rate of 78.6% (p<0,01).

These results indicate that breast cancer patients younger than 35 years of age have higher local and systemic recurrences and poorer DRFS and OS than their older counterparts. These differences may refiect difference in tumor biology and imply that younger patients with breast cancer need both more aggressive and adequate systemic treatment after surgery.