Breast carcinoma in women 35 years of age or younger.

The relationship of the age at diagnosis and prognosis in breast carcinoma remains controversial. A widely held perception is that the disease has a particularly unfavorable prognosis in young women. To examine this question we have studied 166 women treated for primary operable breast carcinoma who were 35 years of age or younger at the time of diagnosis. Groups of patients treated consecutively in each of two time periods nearly a decade apart (1964-1970 and 1976-1979) have been studied. Differences between the patient groups in primary surgical treatment and postoperative adjuvant therapy were characterized in the 1970s by the increasing use of modified radical mastectomy and replacement of postoperative radiation therapy by systemic adjuvant chemotherapy. A trend to earlier stage of disease was found among patients treated in 1976 to 1979, but 5-year recurrence and survival rates were not significantly different from those of young women treated in the 1960s. Comparison of Stage II patients treated in 1964 to 1970 with postoperative radiotherapy with comparable women given adjuvant chemotherapy from 1976 to 1979 revealed no significant difference in disease-free survival in the first 3 years after surgery. It remains to be seen whether these changes in therapy will diminish the frequency of recurrences after 5 years, leading to an improvement in overall survival. When compared with historical controls from this and other institutions, the 5-year and 10-year survival rates of approximately 75% and 60%, respectively, found in this study of young women with primary operative disease were not appreciably different from those of women treated for breast cancer at a later age when the disease is more common.