{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:56:19Z","timestamp":1790916979147,"version":"4.1.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"City of Hope"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Surg Oncol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mastectomy rates in women with breast cancer are higher in younger women than in older women. The impact of this more extensive surgery on overall survival (OS) and locoregional recurrence in younger women is unknown, especially after neoadjuvant systemic therapy (NST). This study evaluated surgical management and outcomes of patients aged \u2264 45 versus &gt; 45 years enrolled in multicenter NST clinical trial, I-SPY2.0 (NCT01042379, PMID 37325931).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary data analysis comparing locoregional treatment in patients aged \u2264 45 versus &gt; 45 years with clinical or molecular high-risk clinical stage II\u2013III breast cancer treated from April 2010 to June 2022. Multivariate Cox proportional hazards models were used to evaluate associations between type of breast surgery with OS and locoregional recurrence-free interval by age group and tumor receptor subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1737 patients, 698 (40.2%) were aged \u2264 45 years. There were no significant differences in patient or tumor characteristics or residual cancer burden distribution between age groups. Although breast-conserving surgery was significantly less common in younger women (36.8% vs 48.5%,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), surgery type was not associated with OS or locoregional recurrence-free interval for patients aged \u2264 45 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Greater extent of breast surgery was not associated with improved outcomes in women aged \u2264 45 years. Choice of surgical procedure in the management of breast cancer is multifactorial, but young age alone\u00a0does not warrant mastectomy following NST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-20153-x","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:49:45Z","timestamp":1785761385000},"page":"9642-9655","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Management of Young Women with High-Risk Breast Cancer Receiving Neoadjuvant Systemic Therapy on the I-SPY2 Trial"],"prefix":"10.1245","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9124-8153","authenticated-orcid":false,"given":"J.","family":"Tseng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Dimitroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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S. Moran's middle initial was corrected.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2026","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1245\/s10434-026-20526-2","URL":"https:\/\/doi.org\/10.1245\/s10434-026-20526-2","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"ISPY2 is supported by QuantumLeap. Jennifer Tseng reports institutional research funding from Intuitive Surgical, Inc. A. Jo Chien reports institutional research funding from Merck, Amgen, Puma, Seagen, Pfizer, and Olema and advisory roles with Pfizer, Ellipses, Gilead, Lilly, and Genentech. Judy Boughey receives support from Eli Lilly, SimBioSys, and MediView paid to her institution. She is on the data safety monitoring committee for Cairn Surgical. Kamran Ahmed reports institutional research funding from Eli Lilly, Genentech, and Gilead. Lily A. Gutnik reports research funding from the American Society of Clinical Oncology (ASCO) and the National Cancer Institute (NCI); she is an unpaid advisory board member for Know Your Lemons, Pretac, and Kibir Desta Foundation. Kelly C. Hewitt is a content author for UptoDate and has received food and travel funding from Intuitive Surgical, Inc. Fumito Ito reports a consulting or advisory role for Otsuka Pharmaceutical Factory. Susan Kesmodel reports research funding from the American Cancer Society, the Breast Cancer Research Foundation, and the Department of Defense. Angela DeMichele reports institutional research funding from Novartis, Pfizer, Genentech, and Neogenomics; she serves as Program Chair for the scientific advisory committee at ASCO. Douglas Yee reports research funding from the National Institutes of Health (NIH)\/NCI P30 CA 077598, P01 CA234228-01. Nola M. Hylton reports institutional research funding from the NIH. Laura J. van 't Veer is an advisor and shareholder of Exai Bio; she is a part-time employee of, and owns stock in, Agendia. Hope S. Rugo reports a consulting or advisory role for Napo, Bristol Myers Squibb, Helsinn, and BioNTech; institutional research funding to her prior institution (UCSF) from AstraZeneca, Gilead Sciences, Inc., Lilly, Merck & Co., Daiichi Sankyo, Inc., Novartis Pharmaceuticals, Pfizer, F. Hoffman-La Roche\/AG\/Genentech, Stemline Therapeutics, and Ambryx; and institutional research funding to City of Hope from Bicycle Therapeutics, F. Hoffman-La Roche\/AG\/Genentech, PhoenixMD, Merck, Relay Therapeutics, ALX Oncology, and Stemline Therapeutics. W. Fraser Symmans reports shares in IONIS Pharmaceuticals and Eiger Biopharmaceuticals; has received consulting fees from AstraZeneca; is a co-founder with equity in Delphi Diagnostics; and has issued patents for (1) a method to calculate residual cancer burden and (2) genomic signature to measure sensitivity to endocrine therapy. Rebecca A. Shatsky holds consulting\/advisory positions with AstraZeneca, Daiichi Sankyo, Genentech, Gilead, Novartis, Mbrace Therapeutics, and Stemline; has received institutional research funding from A2Bio, AstraZeneca, Gilead, Genentech, Greenwich Therapeutics, Nikang Therapeutics, Hummingbird Biosciences, and Regor Therapeutics. Claudine J.D. Isaacs reports institutional research funding from Tesaro\/GSK, Seattle Genetics, Pfizer, AstraZeneca, BMS, Genentech, Novartis, and Regeneron; consultancy roles with AstraZeneca, Genentech, Gilead, ION, Merck, Medscape, MJH Holdings, Novartis, Pfizer, PUMA, and Seagen; and royalties from Wolters Kluwer (UptoDate) and McGraw Hill (Goodman and Gillman). Christina\u00a0Yau\u00a0reports institutional research grant from NCI\/NIH; salary support and travel reimbursement from Quantum Leap Healthcare Collaborative; a US patent titled, \u201cBreast cancer response prediction subtypes\u201d (no. 18\/174,491); and University of California Inventor Share. M. Catherine Lee reports speaker's bureau, Elucent Medicall study funding to institution, Merit Medical; is a minority shareholder of Johnson & Johnson; their spouse is a consultant for Medtronic and serves on the speaker's bureau for Sanofi. Rita Mukhtar reports research funding from GE Healthcare.","order":1,"name":"Ethics","label":"Disclosure","group":{"name":"EthicsHeading","label":"Ethics"}}]}}