Breast-conserving surgery led to improved cancer-specific survival in early breast cancer as compared with mastectomy, with or without radiation therapy, a large retrospective review showed.
Patients treated with breast conservation had significantly higher 5- and 10-year survival, including an 11% absolute difference from mastectomy plus radiation therapy at 10 years, according to researchers of the University of Utah.
Sources and Articles
- Breast-Sparing Tops Mastectomy in New Analysis, MedPageToday, 20 Mar 2014
- Effect of Breast Conservation Therapy vs Mastectomy on Disease-Specific Survival for Early-Stage Breast Cancer, JAMA Surg. 1813803 2014;149(3):267-274. doi:10.1001/jamasurg.2013.3049.
- Breast-Conserving Therapy for Triple-Negative Breast Cancer, JAMA Surg. 1793208 2014;149(3):252-258. doi:10.1001/jamasurg.2013.3037.
- Breast-Conserving Therapy: A Viable Option for Young Women with Early Breast Cancer-Evidence from a Prospective Study, NCBI, PMID: 24599412, 2014 Mar 6
Abstract
BACKGROUND:
This study evaluated the security of breast-conserving treatment (BCT) in young patients and the effect of regional radiation therapy on young patients with 1-3 positive nodes (N+) treated with BCT.
METHODS:
In this prospective concurrent controlled study, 164 patients were defined as the BCT group, and regional radiation therapy was delivered to patients with 1-3 N+. Modified radical mastectomies (MRMs) were performed on 224 patients without regional radiation therapy.
RESULTS:
The 9-year local recurrence (LR) rate of the BCT was 7 %, compared with 3 % in the MRM group (p = 0.055). The 9-year regional recurrence (RR) rate was 6 % for the BCT group and 12 % for the MRM group (p = 0.048). The distant metastasis (DM)-free and breast cancer-specific survival rates were similar between the two groups. RR was an independent prognostic factor for DM [hazard ratio 3.27; 95 % confidence interval (CI) 1.726-6.208] and breast cancer-specific survival (hazard ratio 5.814; 95 % CI 2.690-12.568), whereas LR was not an independent prognostic factor for DM or breast cancer-specific survival.
CONCLUSIONS:
Young patients treated with BCT have a higher LR rate than that of MRM. However, LR has no detrimental effect on DM-free and breast cancer-specific survival rates, whereas RR is a strong risk factor of DM and death. Regional radiation therapy for young patients with 1-3 N+ may reduce RR and improve survival rates.