Breast-conserving surgery vs. total mastectomy in patients with triple negative breast cancer in early stages: A propensity score analysis

2020 ◽  
Vol 39 (1) ◽  
pp. 29-35
Author(s):  
Gabriel De-la-Cruz-Ku ◽  
Bryan Valcarcel ◽  
Zaida Morante ◽  
Mecker G. Möller ◽  
Sofia Lizandro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Propensity Score Analysis ◽  
Breast Conserving Surgery ◽  
Total Mastectomy ◽  
Early Stages ◽  
Score Analysis

scholarly journals Local treatment for triple-negative breast cancer patients undergoing chemotherapy: breast-conserving surgery or total mastectomy?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leqian Guo ◽  
Guilan Xie ◽  
Ruiqi Wang ◽  
Liren Yang ◽  
Landi Sun ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Population Analysis ◽  
Statistical Significance ◽  
Local Treatment ◽  
Breast Conserving Surgery ◽  
Lymph Node Status ◽  
Total Mastectomy ◽  
The Impact

Abstract Background Because there is no exact therapeutic target, the systemic treatment of triple-negative breast cancer (TNBC) still relies on chemotherapy. In terms of local treatment, based on the highly malignant characteristics of TNBC, it is still uncertain whether patients should be given more aggressive local treatment. Methods This study was based on the SEER database. 13,262 TNBC patients undergoing chemotherapy were included. According to local treatment methods, patients were divided into breast-conserving surgery with radiotherapy (BCS + RT), total mastectomy alone and total mastectomy with radiotherapy (Mastectomy+RT). Kaplan-Meier survival analysis drew the survival curves of Overall Survival (OS) and Breast Cancer Specific Survival (BCSS), and Cox proportional risk regression models were used to analyze the impact of different local treatments on OS and BCSS. Results After adjusting confounding factors, Mastectomy alone group (HR = 1.57; 95%CI: 1.40–1.77) and Mastectomy+RT group (HR = 1.28; 95%CI: 1.12–1.46) were worse in OS than BCS + RT group, and Mastectomy+RT group (HR = 0.81; 95%CI: 0.73–0.91) was better in OS than Mastectomy alone group. The effect of local treatment for BCSS was similar to that of OS. After stratification according to age, tumor size and lymph node status, when the age was less than 55 years old, at T4, N2 or N3 category, there was no statistical significance between the BCS + RT group and the Mastectomy+RT group in OS or BCSS (all P > 0.05). When the age was less than 65 years old, at T1, T2 or N0 category, there was no statistical significance between the Mastectomy alone group and the Mastectomy+RT group in OS or BCSS (all P > 0.05). The results of other stratified analyses were basically consistent with the results of total population analysis. Conclusion The survival benefit of breast-conserving surgery with radiotherapy was higher than or similar to that of total mastectomy TNBC patients.

scholarly journals Research on Effectiveness of Prior Cancer on Survival Outcomes for Patients with Nonmetastatic Triple-Negative Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of the SEER Database

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Heyan Chen ◽  
Lutong Yan ◽  
Shengyu Pu ◽  
Lizhe Zhu ◽  
Huimin Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Reference Value ◽  
Breast Conserving Surgery ◽  
Survival Outcomes ◽  
Seer Database ◽  
Term Survival

Introduction. Knowledge of the effect of prior cancer on long-term survival outcomes for patients with nonmetastatic triple-negative breast cancer (TNBC) remained unclear. The aim of this study was to explore and identify the effectiveness of prior cancer on breast cancer-specific death (BCSD) and other cause-specific death (OCSD) in patients with nonmetastatic TNBC. Materials and Methods. Data of 29,594 participants with nonmetastatic TNBC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. Prognostic predictors were identified by propensity score matching (PSM) analysis combined with univariate cumulative incidence function (CIF) and multivariate Fine and Gray competitive risk analyses. Results. Among the women with nonmetastatic TNBC included in the unmatched cohort, a total of 5,375 (18.2%) subjects had prior cancers (P-TNBC) and 24,219 (81.8%) had no prior cancer (NP-TNBC). Patients with P-TNBC tended to have poorer BCSD (Gray’s test, p = 0.0131 ) and OCSD (Gray’s test, p = 0.0009 ) in comparison with those with NP-TNBC after PSM. However, the risk of BCSD p = 0.291 and OCSD p = 0.084 found no difference among P-TNBC patients with one prior cancer and two or more prior cancers after PSM. Additionally, subjects with younger age, advanced T stage, advanced N stage, and advanced differentiation grade tumors were likely to develop BCSD, whereas those with breast-conserving surgery (BCS), radiotherapy, or chemotherapy tended to have a lower incidence of BCSD. Conclusion. Our study demonstrated that prior cancer was related to the worse BCSD and OCSD rate and could be identified as a reliable survival predictor for patients with nonmetastatic TNBC. This study may provide some reference value for the treatment mode of TNBC patients with prior cancer in the future.

Breast-Conserving Therapy is Associated with Better Survival than Mastectomy in Early-Stage Breast Cancer: A Propensity Score Analysis

2021 ◽  
Author(s):  
Jiali Ji ◽  
Shushu Yuan ◽  
Jiawei He ◽  
Hong Liu ◽  
Lei Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Breast Conserving Therapy ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Kaplan Meier ◽  
Score Analysis

Abstract Background: Recent retrospective studies have reported that breast-conserving therapy (BCT) led to improved overall survival (OS) than mastectomy in some populations. We aimed to compare the efficacy of BCT and mastectomy using the SEER database. Methods: Between 2010 and 2015, 99,790 eligible patients were identified. We included early-stage breast cancer patients with 5cm or smaller tumors and three or fewer positive lymph nodes in our study. We compared the OS results among patients with BCT and mastectomy. Kaplan-Meier plots, Cox proportional hazard regressions were used to evaluate the outcomes. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: In our study, 77,452 (77.6%) patients underwent BCT and 22,338 (22.4%) underwent mastectomy. The 5-year OS rate was 94.7% in the BCT group and 87.6% in the mastectomy group (P <0.001). After matching, multivariate analysis in the matched cohort showed that women underwent mastectomy was associated with worse OS results compared with those with BCT (Hazard ratio (HR) = 1.628; 95% confidence intervals (CIs) = 1.445- 1.834, P<0.001). Patients with different subtypes and age group (>50 years old; ≤50 years old) received BCT all showed significantly better OS than those received mastectomy. The effect of surgery choice on survival was the same in matched and all cohorts. Conclusions: Our study showed that BCT was associated with improved survival compared with mastectomy in early-stage breast cancer patients. It seems advisable to encourage patients to receive BCT rather than mastectomy in early-stage patients when feasible and appropriate.

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