Dominici L, Hu J, Zheng Y, et al. - Poorer quality-of-life outcomes in relation to more extensive surgery were seen in young breast cancer survivors, especially in those who underwent mastectomy and radiotherapy, regardless of reconstruction. Socioeconomic stressors also seem to play a role.

• This is a cross-sectional study of a prospective cohort, including 560 women (40 years or younger) with stage 0 to III breast cancer.

• Bilateral mastectomy, unilateral mastectomy, and breast-conserving therapy were received by 52%, 20%, and 28% of the patients, respectively.

• Among mastectomy patients, 357 (89%) underwent reconstruction and 181 (45%) had radiotherapy.

• Decreased breast satisfaction and psychosocial and sexual well-being was observed with unilateral or bilateral mastectomy with radiotherapy (vs breast-conserving therapy).