NSABP Protocol B-06: A randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer — Results after 15 years of follow-up

Wickerham, D. Lawrence; Anderson, Seri; Fisher, B; Margolese, R; Mamounas, T.; Wolmark, Norman

doi:10.1016/s0959-8049(98)80142-1

Cited by 4 publications

(1 citation statement)

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“…However, variability in surgical practice may be a problem to face today [11] [12], with moderate-to-high variability in the performance of surgical treatment of breast cancer [10] [13] [14] [15]. After the two seminal randomized trials for breast conservation surgery, NSAPB-B06 trial [16] and Veronesi's Italian trial [17], were published, several studies have compared mastectomy with conservative surgery for the treatment of breast cancer. In some of them, no difference in mortality has been observed, although in others, the results on mortality and recurrence are discordant in some aspects.…”

Section: Introductionmentioning

confidence: 99%

Influence of Surgical Treatment on Complications, Readmissions and Clinical Progress of Breast Cancer in Women Participating in Breast Cancer Screening Programs

Blay

Jansana

Louro

et al. 2021

Preprint

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BackgroundComplications and readmissions derived from surgical treatment of breast cancer have been scarcely evaluated. The studies that compare mastectomy with conservative, usually focus only in recurrence and/or mortality and sometimes the results are discordant in some aspects. The aim of this study was to analyze complications and readmissions, recurrence and mortality, according to the surgical treatment received in the mammary gland.Methods This multicenter study included 1086 women diagnosed with breast cancer from the CaMISS cohort study of women aged between 50 and 69 years participating in 4 breast cancer screening programs in Spain between 2000 and 2009 with a follow up until 2014. Multivariate models were used to estimate the adjusted odds ratio of breast surgery (mastectomy vs conservative treatment) for complications and readmissions and hazard ratios for recurrences and mortality.Results Primary breast surgical treatment consisted of conservative treatment in 821 women (80.1%) and mastectomy in 204 (19.9%). Mastectomy was associated with readmissions, recurrences and mortality but this association was not statistically significant on multivariate adjusted analysis (ORa=1.51 [95%CI 0.89-2.57], HRa=1.37 [95%CI 0.85-2.19] and HRa=1.52 [95%CI 0.95-2.43] respectively). In our sample, the variables with greatest impact on complications, recurrences and mortality were stages III and IV (ORa=4.4 [95%CI 1.22-16.16], HRa=7.96 [95%CI 3.32-19.06] and HRa=3.92 [95%CI 1.77-8.67]). Conclusion Complications, readmissions, recurrence and mortality were similar in both surgical techniques. These results support that surgical treatment for breast cancer can be adapted to professional and health system circumstances, and to the surgical needs and desires of each patient.

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