Background and Aims Young breast cancer patients carrying germline BRCA (gBRCA) mutations face a dual risk associated with both a young age and genetic mutations. Currently, there is no consensus on the feasibility of breast-conserving therapy for early-stage breast cancer patients with gBRCA mutations. This study was conducted to explore the impact of different surgical methods on the prognosis of young breast cancer patients with gBRCA mutations as well as to investigate whether this impact varies among different ethnic groups through a Meta-analysis.Methods Multiple international databases were searched to collect clinical studies comparing the prognosis of early-stage breast cancer patients with gBRCA mutations undergoing breast-conserving surgery versus total mastectomy. Meta-analysis was performed on variables that included recurrence-free survival (RFS), metastasis-free survival (MFS), breast cancer-specific survival (BCSS), and overall survival (OS).Results Six studies (2 from China, 4 from Europe and the United States) were finally included, comprising a total of 2 140 patients with gBRCA mutations, with a median age ranging from 38 to 47 years. The Meta-analysis results indicated that, in the overall population, breast cancer patients with gBRCA mutations undergoing breast-conserving surgery had an increased risk of recurrence compared to those undergoing total mastectomy (RFS: HR=1.91, 95% CI=1.03-3.54, P<0.05). However, there were no statistically significant differences in MFS, BCSS, and OS between the two surgical procedures (all P>0.05). In the Chinese population, patients with gBRCA mutations undergoing breast-conserving surgery had a higher risk of recurrence compared to those undergoing total mastectomy (RFS: HR=1.63, 95% CI=1.10-2.41, P<0.05), with no statistically significant differences in other variables (all P>0.05). In the European and American populations, there were no statistically significant differences in all above variables between the two surgical methods (all P>0.05).Conclusion For the European and American populations, breast-conserving surgery is not a risk factor for the postoperative prognosis of young breast cancer patients with gBRCA mutations. However, in the Chinese population, opting for breast-conserving surgery may entail a higher risk of recurrence for young breast cancer patients with gBRCA mutations; therefore, a full information should be provided during medical decision of surgical choice.