Observational studyAnnals of surgery2017
Local Recurrence and Breast Oncological Surgery in Young Women With Breast Cancer: The POSH Observational Cohort Study.
Observational study in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Margin status and survival outcomes after breast cancer conservation surgery: prospectively registered systematic review and meta-analysis.BMJ (Clinical research ed.) · 2022Pooled it
- Breast Conservation Therapy vs. Mastectomy Survival in Young Breast Cancer Patients: Systematic Review and Meta-Analysis.Breast care (Basel, Switzerland) · 2026Review
- Association between molecular subtypes of breast cancer and surgical margin status analysis from Assam, India.Discover oncology · 2026Article
- Prone-to-Supine Breast MRI for Tumor Margin Visibility and Surgical Guidance.Journal of breast imaging · 2026Article
- Distant recurrence and margin involvement in invasive breast cancer.British journal of cancer · 2026Article
- Article
- Proteogenomic characterization of invasive breast tumors in young women.NPJ breast cancer · 2025Article
- Long-Term Locoregional Outcomes in a Contemporary Cohort of Young Women With Breast Cancer.JAMA surgery · 2025Article
- Great Debate: Does Breast-Conserving Surgery with Radiotherapy Offer Better Survival than Mastectomy in Early-Stage Breast Cancer?Annals of surgical oncology · 2025Article
- 15-Year Survival Outcome of Primary Breast Conservation Therapy in Young Women with Breast Cancer.Indian journal of surgical oncology · 2025Article
- Patient-reported outcomes and quality of life after breast-conserving surgery, mastectomy, and breast reconstruction assessed using the BREAST-Q questionnaire.Breast cancer research and treatment · 2024Article
- Distribution characteristics of immune infiltration and lymphovascular invasion in patients with breast cancer skin recurrence.Cancer immunology, immunotherapy : CII · 2024Article
- Prognostic Impact of Surgical Margin Status on Overall Survival of Patients with Early Breast Cancer: A Retrospective Analysis from the Department for Women's Medicine at Charité - University Hospital Berlin.Geburtshilfe und Frauenheilkunde · 2024Article
- A New Approach to Breast Specimen Orientation: Avoiding Pitfalls with the Specimen Plate Concept.Current oncology (Toronto, Ont.) · 2024Article
- Risk of first recurrence after treatment in a population-based cohort of young women with breast cancer.Breast cancer research and treatment · 2024Article
- Predicting disease recurrence in breast cancer patients using machine learning models with clinical and radiomic characteristics: a retrospective study.Journal of the Egyptian National Cancer Institute · 2024Article
- The impact of loco-regional treatment modality on the outcomes in breast cancer patients younger than forty years of age.BMC cancer · 2024Article
- Association of clinicopathologic and molecular factors with the occurrence of positive margins in breast cancer.Breast cancer research and treatment · 2024Article
- Development and validation of a random survival forest model for predicting long-term survival of early-stage young breast cancer patients based on the SEER database and an external validation cohort.American journal of cancer research · 2024Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo assess clinical and surgical factors affecting local recurrence and survival in young breast cancer patients in the Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH).
backgroundEmerging data suggest young age is a predictor of increased local recurrence.
methodsPOSH is a prospective cohort of 3024 women of 18 to 40 years with breast cancer. Cohort characteristics were grouped by mastectomy or BCS. Endpoints were local-recurrence interval (LRI), distant disease-free interval (DDFI), and overall survival (OS); described using cumulative-hazard and Kaplan-Meier plots and multivariable analyses by Flexible Parametric and Cox regression models.
resultsMastectomy was performed in 1464 patients and breast-conserving surgery (BCS) in 1395. Patients undergoing mastectomy had larger tumors and higher proportions of positive family history, estrogen receptor+, progesterone receptor+, and/or human epidermal growth factor receptor 2+ tumors. Local events accounted for 15% of recurrences. LRI by surgical type varied over time with LRI similar at 18 months (1.0% vs 1.0%, P = 0.348) but higher for BCS at 5 and 10 years (5.3% vs 2.6%, P < 0.001; and 11.7% vs 4.9%, P < 0.001, respectively). Similar results were found in the adjusted model. Conversely, distant-metastases and deaths were lower for BCS but not after adjusting for prognostic factors. After mastectomy chest-wall radiotherapy was associated with improved LRI (hazard ratio, HR = 0.46, P = 0.015). Positive surgical margins, and development of local recurrence predicted for reduced DDFI (HR = 0.50, P < 0.001; and HR = 0.29, P = 0.001, respectively).
conclusionsSurgical extent appears less important for DDFI than completeness of excision or, where appropriate, chest-wall radiotherapy. Despite higher local-recurrence rates for BCS, surgical type does not influence DDFI or OS after adjusting for known prognostic factors in young breast cancer patients.
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