Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer
In the current study, we sought to compare survival outcomes after breast-conserving therapy (BCT) or mastectomy alone in patients with stage I-IIA breast cancer, whose tumors are typically suitable for both locoregional treatments. The study cohort consisted of 1360 patients with stage I-IIA (T1–2N...
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MDPI AG
2021-08-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/16/4044 |
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| author | Ivica Ratosa Gaber Plavc Nina Pislar Tina Zagar Andraz Perhavec Pierfrancesco Franco |
| author_facet | Ivica Ratosa Gaber Plavc Nina Pislar Tina Zagar Andraz Perhavec Pierfrancesco Franco |
| author_sort | Ivica Ratosa |
| collection | DOAJ |
| description | In the current study, we sought to compare survival outcomes after breast-conserving therapy (BCT) or mastectomy alone in patients with stage I-IIA breast cancer, whose tumors are typically suitable for both locoregional treatments. The study cohort consisted of 1360 patients with stage I-IIA (T1–2N0 or T0–1N1) breast cancer diagnosed between 2001 and 2013 and treated with either BCT (<i>n</i> = 1021, 75.1%) or mastectomy alone (<i>n</i> = 339, 24.9%). Median follow-ups for disease-free survival (DFS) and overall survival (OS) were 6.9 years (range, 0.3–15.9) and 7.5 years (range, 0.2–25.9), respectively. Fifteen (1.1%), 14 (1.0%) and 48 (3.5%) patients experienced local, regional, and distant relapse, respectively. For the whole cohort of patients, the estimated 5-year DFS and OS were 96% and 97%, respectively. After stratification based on the type of local treatment, the estimated 5-year DFS for BCT was 97%, while it was 91% (<i>p</i> < 0.001) for mastectomy-only treatment. Inverse probability of treatment weighting matching based on confounding confirmed that mastectomy was associated with worse DFS (HR 2.839, 95% CI 1.760–4.579, <i>p</i> < 0.0001), but not with OS (HR 1.455, 95% CI 0.844–2.511, <i>p</i> = 0.177). In our study, BCT was shown to have improved disease-specific outcomes compared to mastectomy alone, emphasizing the important role of adjuvant treatments, including postoperative radiation therapy, in patients with early-stage breast cancer at diagnosis. |
| first_indexed | 2024-03-10T08:57:44Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T08:57:44Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a2ffc19289084f27a8aec6d1010b6e592023-11-22T07:02:56ZengMDPI AGCancers2072-66942021-08-011316404410.3390/cancers13164044Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast CancerIvica Ratosa0Gaber Plavc1Nina Pislar2Tina Zagar3Andraz Perhavec4Pierfrancesco Franco5Department of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, SloveniaDepartment of Radiation Oncology, Institute of Oncology Ljubljana, 1000 Ljubljana, SloveniaDepartment of Surgery, Institute of Oncology Ljubljana, 1000 Ljubljana, SloveniaDepartment of Epidemiology and Cancer Registry, Institute of Oncology Ljubljana, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, 1000 Ljubljana, SloveniaDepartment of Translational Medicine, University of Eastern Piedmont, 28100 Novara, ItalyIn the current study, we sought to compare survival outcomes after breast-conserving therapy (BCT) or mastectomy alone in patients with stage I-IIA breast cancer, whose tumors are typically suitable for both locoregional treatments. The study cohort consisted of 1360 patients with stage I-IIA (T1–2N0 or T0–1N1) breast cancer diagnosed between 2001 and 2013 and treated with either BCT (<i>n</i> = 1021, 75.1%) or mastectomy alone (<i>n</i> = 339, 24.9%). Median follow-ups for disease-free survival (DFS) and overall survival (OS) were 6.9 years (range, 0.3–15.9) and 7.5 years (range, 0.2–25.9), respectively. Fifteen (1.1%), 14 (1.0%) and 48 (3.5%) patients experienced local, regional, and distant relapse, respectively. For the whole cohort of patients, the estimated 5-year DFS and OS were 96% and 97%, respectively. After stratification based on the type of local treatment, the estimated 5-year DFS for BCT was 97%, while it was 91% (<i>p</i> < 0.001) for mastectomy-only treatment. Inverse probability of treatment weighting matching based on confounding confirmed that mastectomy was associated with worse DFS (HR 2.839, 95% CI 1.760–4.579, <i>p</i> < 0.0001), but not with OS (HR 1.455, 95% CI 0.844–2.511, <i>p</i> = 0.177). In our study, BCT was shown to have improved disease-specific outcomes compared to mastectomy alone, emphasizing the important role of adjuvant treatments, including postoperative radiation therapy, in patients with early-stage breast cancer at diagnosis.https://www.mdpi.com/2072-6694/13/16/4044early-stage breast cancerbreast-conserving therapymastectomyradiation therapyoutcome |
| spellingShingle | Ivica Ratosa Gaber Plavc Nina Pislar Tina Zagar Andraz Perhavec Pierfrancesco Franco Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer Cancers early-stage breast cancer breast-conserving therapy mastectomy radiation therapy outcome |
| title | Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer |
| title_full | Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer |
| title_fullStr | Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer |
| title_full_unstemmed | Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer |
| title_short | Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer |
| title_sort | improved survival after breast conserving therapy compared with mastectomy in stage i iia breast cancer |
| topic | early-stage breast cancer breast-conserving therapy mastectomy radiation therapy outcome |
| url | https://www.mdpi.com/2072-6694/13/16/4044 |
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