Surgical treatment options in young women with breast cancer

The diagnosis of breast cancer in young women presents particular challenges in surgical decision making and treatment. These challenges arise from concurrent genetic or other risk factors, potentially more aggressive tumor biology, larger tumor size, and psychosocial factors unique to young women. Local recurrence and survival rates for breast-conserving surgery compared to mastectomy are reviewed and strategies for reducing local recurrence after breast conserving therapy are discussed. Options for incorporating genetic testing and counseling into surgical management are presented. Management of young women with BRCA gene mutations, with a positive family history without a risk gene mutation, and with a history of mantle irradiation for Hodgkin's disease is discussed.