Improved Survival after Breast-Conserving Therapy Compared with Mastectomy in Stage I-IIA Breast Cancer

Abstract

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 (n = 1021, 75.1%) or mastectomy alone (n = 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% (p < 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, p < 0.0001), but not with OS (HR 1.455, 95% CI 0.844–2.511, p = 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.

The Intercostal Artery Perforator Flap

“…Several studies have supported that breast-conserving therapy may be superior to mastectomy in regard to survival 1–9,17–23 . Compared with BCT, mastectomies inherently carry a host of risks including higher rates of skin flap necrosis, postoperative hematoma, lymphedema, and nerve injury 24 .…”

“…Several studies have supported that breast-conserving therapy may be superior to mastectomy in regard to survival. [1][2][3][4][5][6][7][8][9][17][18][19][20][21][22][23] Compared with BCT, mastectomies inherently carry a host of risks including higher rates of skin flap necrosis, postoperative hematoma, lymphedema, and nerve injury. 24 Moreover, mastectomies lead to a healthcare burden requiring hospital stays, increased pain, and often a need for additional staged procedures.…”

Prognosis of breast-conserving surgery versus total mastectomy in young breast cancer patients based on SEER and Hebei Province cohort

“…In subgroup forest plot analysis, we observed that in the area of radiotherapy, BCS plus radiotherapy improved OS in patients receiving radiotherapy, and BCS had a better prognosis for these breast cancer patients.BCS plus radiotherapy (BCT) refers to breast-conserving surgery followed by radiation therapy to eradicate any microscopic residual disease, and the e cacy of BCT has been evaluated in clinical trials over the past decades and, in addition to being cosmetically acceptable, it provides survival rates comparable to total mastectomy, especially in early-stage patients, allowing for additional survival bene ts [9,12,18,23,24] . In a further study, we compared the prognosis of patients who underwent BCT with those who underwent TM, and we found no statistical difference in OS between BCT and TM, but the prognosis of BCT patients was better than that of TM patients who underwent radiotherapy, which may be due to the greater extent of surgery and larger incisions in TM patients, which tend to cause a decrease in immunity and less recovery, but for now, the relationship between surgical trauma, adjuvant therapy and immune response relationship is still unknown [15] .…”

Smart Biosensor for Breast Cancer Survival Prediction Based on Multi-View Multi-Way Graph Learning

“…This disease stems from genetic abnormalities that lead to the production of faulty proteins, culminating in uncontrolled cell proliferation and the formation of breast tumors [ 4 ]. Breast cancer is categorized into various stages based on factors such as tumor size, location, and other parameters, each necessitating tailored treatment modalities [ 5 ]. Accurately predicting survival time is imperative for guiding clinicians in prognosis and devising personalized treatment strategies.…”