Breast-conserving surgery versus mastectomy for treatment of breast cancer after neoadjuvant chemotherapy

Frontiers in Oncology

Oncology

Hao Jing¹  Hui Fang¹  Ye-Xiong Li¹  Yue-Ping Liu¹  Ning Li¹  Yong-Wen Song¹  Yu-Chun Song¹  Bo Chen¹  Yu Tang¹  Yuan Tang¹  Shu-Nan Qi¹  Ning-Ning Lu¹  Shu-Lian Wang¹  Jing Jin²  Zhou Huang³ 

[1] Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital &Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China;Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China;

关键词: breast cancer;    neoadjuvant chemotherapy;    breast-conserving surgery;    mastectomy;    oncological outcomes;   

DOI  :  10.3389/fonc.2023.1178230

 received in 2023-03-02, accepted in 2023-06-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundTo compare recurrence and survival outcomes between breast-conserving surgery (BCS) and mastectomy after neoadjuvant chemotherapy (NACT).MethodsThe data of 730 patients who underwent NACT between 2000 and 2014 were retrospectively reviewed. A total of 104 (14.2%) patients received BCS and 626 (85.8%) received mastectomy. Locoregional recurrence (LRR), distant metastases (DM), disease-free survival (DFS), breast cancer–specific survival (BCSS), and overall survival (OS) were analyzed using the Kaplan–Meier method. The impact of BCS versus mastectomy on outcomes was assessed by multivariate Cox models. Inverse probability of treatment weighting (IPTW) was used to balance covariates between the two groups.ResultsThe median follow-up of BCS and mastectomy groups were 86.5 and 87.4 months, respectively. There were significant differences in distribution of most baseline characteristics between two groups. Compared with those who underwent mastectomy, the patients with BCS had similar 5-year LRR, DM, and DFS rates, but had significantly higher 5-year BCSS (98.9% vs. 90.4%, P = 0.005) and OS (98.9% vs. 90.1%, P = 0.003) rates. Multivariate analysis also showed that BCS significantly improved BCSS (HR = 0.27, 95% CI: 0.08-0.85, P = 0.025) and OS (HR = 0.25, 95% CI: 0.08-0.79, P = 0.018). After IPTW adjustment, the LRR, DM, DFS, BCSS and OS between two groups had no significant differences.ConclusionsThe recurrence and survival outcomes are comparable with BCS and mastectomy. Thus, BCS is a safe treatment option for selected breast cancer patients after NACT.

【 授权许可】

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Copyright © 2023 Song, Huang, Fang, Tang, Jing, Song, Jin, Liu, Chen, Tang, Qi, Lu, Li, Li and Wang