Women diagnosed with breast cancer at age 40 or younger experience a notably low risk of isolated locoregional recurrence (LRR), according to a recent study published in JAMA Surgery on July 23, 2025. Led by Laura S. Dominici, M.D., from Brigham and Women’s Hospital in Boston, the research highlights the long-term incidence of isolated LRR across different molecular subtypes in a multicenter prospective cohort study.
The study followed 1,135 women diagnosed with stage I through III breast cancer between 2006 and 2016, with a median follow-up period of 10.1 years. The cohort was categorized by age at diagnosis: 12.8% were under 30 years, 28.0% were between 31 and 35 years, and 59.2% were aged 36 to 40 years.
During the follow-up, researchers recorded 59 isolated local recurrences and four isolated regional recurrences, resulting in rates of 5.2% and 0.4%, respectively. The cumulative incidence of LRR at 10.1 years varied by molecular subtype, with rates of 4.4% for luminal A, 4.7% for luminal B, 6.1% for luminal ERBB2+, 2.2% for ERBB2+, and 6.5% for triple-negative.
Cumulative Incidence by Treatment Type
The cumulative incidence of LRR also differed based on the type of locoregional treatment received. After breast-conserving therapy, the incidence was 6.7%, while it was 6.5% after mastectomy without radiation and 2.4% following mastectomy with radiation. Notably, multivariable analysis indicated that mastectomy with radiation was associated with the lowest risk for LRR, although no significant differences were identified among the different molecular subtypes.
The authors of the study expressed optimism regarding the findings. They noted, “Reassuringly, in this large contemporary study of women diagnosed with breast cancer at age 40 years and undertreated with modern local and systemic therapy, we observed overall low rates of isolated LRR in long-term follow-up, with no significant differences by local therapy strategy when compared within tumor subtype.”
Importance of Long-Term Follow-Up
The study underscores the importance of extended follow-up for young women diagnosed with breast cancer, given the increasing number of such diagnoses. Understanding the long-term risk of LRR is crucial for improving patient care and outcomes. Several authors associated with the study disclosed ties to the biopharmaceutical industry, emphasizing the need for transparency in medical research.
For further details on the study, refer to the original work by Laura S. Dominici et al titled “Long-Term Locoregional Outcomes in a Contemporary Cohort of Young Women With Breast Cancer,” published in JAMA Surgery, DOI: 10.1001/jamasurg.2025.2324.
