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help our patients with hypospadias. Breast cancer diagnosis at a very young age has been independently correlated with worse outcomes. Appropriately intensifying treatment in these patients is warranted, even as we acknowledge the risks of potentially mutagenic adjuvant therapies. We examined local control, distant control, overall survival, and secondary malignancy rates by age cohort and by initial surgical strategy. Female patients less than or equal to 35 years of age diagnosed with invasive breast cancer from January 1, 1990, to