{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:50:21Z","timestamp":1792183821409,"version":"4.4.0"},"reference-count":29,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:00:00Z","timestamp":1760140800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Breast Care"],"abstract":"<jats:p>Background: While young breast cancer patients exhibit lower overall survival (OS) than older groups, it remains unclear whether OS differs between breast-conserving therapy (BCT) and mastectomy specifically in this younger population. Although BCT carries a higher recurrence risk than mastectomy in young patients, OS appears similar across all ages. This meta-analysis therefore directly compares OS and breast cancer specific survival (BCSS) in young patients treated with BCT versus mastectomy. Methods: Our review included 6 studies that compared OS between BCT and mastectomy in patients aged 40 years or younger diagnosed with stage I-III breast cancer. The endpoint was OS\/BCSS, and only studies presenting hazard ratios (HRs) were included in the analysis. Meta-analyses used inverse-variance random effects (REML with Hartung-Knapp confidence intervals [CIs]); heterogeneity was assessed with Q and I2. Leave-one-out, fixed-effect, and DerSimonian-Laird models tested robustness; Egger\u2019s test explored small-study effects. Analyses were performed in RevMan 5.3 and Stata 17, with p &lt; 0.05 or 95% CIs excluding 1.00 considered significant. Results: OS showed no difference between BCT and mastectomy (pooled HR = 0.99, 95% CI: 0.88\u20131.10, I2 = 54%). BCSS favored BCT with a small but significant reduction in mortality (HR 0.92, 95% CI: 0.86\u20130.98, I2 = 0%). Subgroup analyses of OS suggested stage dependence: benefit with T1\u20132 (HR 0.93, 0.87\u20130.99) and N0\u20131 (HR 0.93, 0.87\u20130.99), but no advantage in T1\u20133 or N2\u20133 disease (both HR 1.19, 0.99\u20131.44). Leave-one-out and model checks did not change inference; unadjusted estimates suggested benefit but this attenuated after adjustment. Conclusion: In women \u226440 years with stage I\u2013III breast cancer, BCT with radiotherapy achieves OS comparable to mastectomy and may yield a modest BCSS benefit, particularly in lower-burden disease (T1-2 or N0\u20131). Given the observational nature of the evidence and residual heterogeneity, results should be interpreted cautiously and individualized clinical decision-making is recommended; randomized or prospectively adjusted data are still needed.<\/jats:p>","DOI":"10.1159\/000548895","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T16:00:45Z","timestamp":1760198445000},"page":"240-252","source":"Crossref","is-referenced-by-count":1,"title":["Breast Conservation Therapy vs. Mastectomy Survival in Young Breast Cancer Patients: Systematic Review and 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