Improved Long-term Survival with Contralateral Mastectomy in Young Women

With an estimated 226,870 diagnoses and 39,510 deaths in 2012, breast cancer remains the most commonly occurring and second most lethal cancer among women in the United States (Howlader et al., 2011). Among those with breast cancer, patients aged less than 40 remain a particular challenge due, in part, to the inherent biologic aggressiveness of their tumors. Young women have tumors that are more likely to be high-grade histopathologically; have a higher mitotic rate with lymphovascular invasion (LVI); have more pathologic LNs; and are more likely to be hormone receptor (HR) negative/HER2 negative (“triple negative”; Colleoni et al., 2002; Carey et al., 2006; Anders et al., 2008, Kurian et al., 2009; Lund et al., 2009; Telli et al., 2011; Ademuyiwa et al., 2013; de la Rochefordiere et al., 2013). Moreover, the patients are more likely to be black, have a family history of breast cancer, and have less favorable outcomes (Adami et al.,