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Abstract：
Background: Breast cancer in young women aged < 40 years is rare and often aggressive with less favorable survival rates. The lack of systematic screening, later stage at diagnosis, and a more aggressive disease biology may all contribute to their poor prognosis. Data on the best management remain conflicting, especially those regarding surgical management, either breast-conserving or mastectomy. To our knowledge, there are limited studies surrounding the treatment of young women with early breast cancer, and this analysis evaluated the oncological outcomes for those patients who underwent surgery upfront. Methods: We conducted a retrospective study including 130 young women with early breast cancer from a total of 373 consecutive patients treated with upfront surgery between January 2016 and December 2021 at our institution. Local recurrence-free survival (LR-FS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated. Results: The median follow-up was 61.1 months (range, 25-95). A total of 92 (70.8%) patients underwent breast-conserving surgery, while 38 (29.2%) patients underwent conservative mastectomy with immediate implant breast reconstruction. In total, 8 of 130 patients (6.2%) developed a local recurrence in the treated breast, an7 (5.4%) patients presented distant metastasis. Overall, two (1.6%) patients died due to breast cancer recurrence. Conclusions: The results of our study interestingly support breast-conserving surgery in young patients with early-stage breast cancer. While appropriate breast-conserving surgery can achieve favorable oncological outcomes and can always be considered a valid alternative to conservative mastectomy in upfront surgery, a younger age at diagnosis should never be used alone to choose the type of surgery.
摘要：
背景：年龄<40岁的年轻女性的乳腺癌是罕见的，通常具有侵袭性，生存率较差。缺乏系统的筛查，在诊断的后期阶段，和更具侵略性的疾病生物学可能都有助于他们的不良预后。关于最佳管理的数据仍然相互矛盾，尤其是那些关于手术管理的，保乳或乳房切除术.据我们所知,关于治疗年轻女性早期乳腺癌的研究有限，这项分析评估了那些预先接受手术的患者的肿瘤结局。方法：我们进行了一项回顾性研究，包括2016年1月至2021年12月在我们机构接受前期手术治疗的373例连续患者中的130例早期乳腺癌年轻女性。无局部复发生存率（LR-FS），无远处转移生存期（DMFS），无病生存率（DFS），评估总生存期(OS)。结果:中位随访时间为61.1个月(范围,25-95).共有92例(70.8%)患者接受了保乳手术,38例（29.2％）患者接受了保守性乳房切除术并立即植入乳房重建。总的来说,130例患者中有8例（6.2％）在接受治疗的乳房中出现了局部复发，an7例(5.4%)患者出现远处转移。总的来说,两名(1.6%)患者死于乳腺癌复发.结论：我们的研究结果有趣地支持年轻早期乳腺癌患者的保乳手术。虽然适当的保乳手术可以获得良好的肿瘤学结果，并且在前期手术中始终可以被认为是保守乳房切除术的有效替代方案。诊断时年龄较小，不应单独选择手术类型。
