Abstract
-
Objectives
- Breast conserving surgery (BCS) for early breast cancer is now an accepted treatment, but there are controversies about its comparability with mastectomy. Thus, we investigated the survival outcomes who underwent BCS and modified radical mastectomy (MRM).
-
Methods
- In this retrospective review, we analyzed the survival outcomes of 618 patients with early breast cancer who underwent two different surgery from January 2002 to December 2009. Postoperative pathologic difference, disease free survival period, overall survival period, recurrence pattern, recurrent rate and site were compared. In addition, preoperative patients data are also collected.
-
Results
- Disease free survival period of MRM and BCS was 108.46 months and 80.82 months, respectively (P< 0.01). However, there was no significant correlation between overall survival period and operative methods (P= 0.67). In addition, recurrence pattern (P= 0.21), recurrent rate (P= 0.36) and site (P= 0.45, P= 0.09) were not associated with operative method.
-
Conclusions
- In this study, we can suggest that early breast cancer patients could improve their disease free survival if they underwent MRM. So, when we operate high risk breast cancer patients, MRM could be considered for their disease free life. Further studies may be required to establish appropriate strategy of surgery for early breast cancer.
-
Keywords: Key Words; Breast conserving surgery; Disease free survival; Early breast cancer; Modified radical mastectomy
Fig. 1.Disease free survival curves between MRM and BCS.
Fig. 2.Overall survival curves between MRM and BCS.
Table 1.Clinicopathologic characteristics
|
No. (%) |
MRM (%) |
BCS (%) |
P-value |
Total |
618 (100) |
91 (100) |
527 (100) |
|
Age (year) |
|
|
|
0.63 |
<40 |
92 (14.9) |
15 (16.5) |
77 (14.6) |
|
≥ 40 |
526 (85.1) |
76 (83.5) |
450 (85.4) |
|
T stage |
|
|
|
0.82 |
T1 |
324 (52.4) |
49 (53.8) |
275 (52.2) |
|
T2 |
294 (47.6) |
42 (46.2) |
252 (47.8) |
|
N stage |
|
|
|
1.00 |
N0 |
539 (87.2) |
80 (87.9) |
459 (87.1) |
|
N1 |
79 (12.8) |
11 (12.1) |
68 (12.9) |
|
Estrogen receptor |
|
|
|
0.14 |
(+) |
336 (54.4) |
56 (61.5) |
280 (53.1) |
|
(-) |
282 (45.6) |
35 (38.5) |
247 (46.9) |
|
Progesterone receptor |
|
|
|
0.31 |
(+) |
299 (48.4) |
49 (53.8) |
250 (47.4) |
|
(-) |
319 (51.6) |
42 (46.2) |
277 (52.6) |
|
HER-2 expression |
|
|
|
0.11 |
(+) |
336 (54.4) |
42 (46.2) |
294 (55.8) |
|
(-) |
272 (45.6) |
49 (53.8) |
233 (44.2) |
|
Histologic grade |
|
|
|
0.07 |
I |
119 (19.2) |
22 (24.2) |
97 (18.4) |
|
II |
221 (35.8) |
38 (41.7) |
183 (34.7) |
|
III |
278 (45.0) |
31 (34.1) |
247 (46.9) |
|
Lymphatic invasion |
|
|
|
0.45 |
(+) |
171 (27.7) |
22 (24.2) |
149 (28.3) |
|
(-) |
447 (72.3) |
69 (75.8) |
378 (71.7) |
|
Vascular invasion |
|
|
|
1.00 |
(+) |
175 (28.3) |
26 (28.6) |
149 (28.3) |
|
(-) |
443 (71.7) |
65 (71.4) |
378 (71.7) |
|
Molecular subtype |
|
|
|
0.18 |
Luminal A |
204 (33.0) |
38 (41.8) |
166 (31.5) |
|
Luminal B |
205 (33.2) |
29 (31.9) |
176 (33.4) |
|
HER-2+ |
131 (21.2) |
13 (14.3) |
118 (22.4) |
|
Triple negative |
78 (12.6) |
11 (12.1) |
67 (12.7) |
|
Table 2.Disease free survival period and overall survival period between MRM and BCS group
|
Mean time (month) |
95% CI |
HR |
P-value |
Disease free survival |
|
|
0.36 |
<0.01 |
MRM |
108.46 |
96.32-120.61 |
|
|
BCS |
80.82 |
71.75-89.89 |
|
|
Overall survival |
|
|
0.71 |
0.67 |
MRM |
119.25 |
108.27–130.24 |
|
|
BCS |
121.96 |
110.76–133.15 |
|
|
Table 3.Postoperative recurrence pattern, recurrent rate site between MRM and BCS group
|
MRM (%) |
BCS (%) |
P-value |
Total |
10 (100) |
49 (100) |
0.36 |
Recurrence pattern |
|
|
0.21 |
Local recurrence |
1 (10.0) |
14 (28.6) |
|
Systemic recurrence |
9 (90.0) |
35 (71.4) |
|
Local recurrent site |
|
|
0.23 |
Ipsilateral chest wall |
1 (10.0) |
2 (4.1) |
|
Ipsilateral breast |
0 (0) |
3 (6.1) |
|
Supraclavicular node |
0 (0) |
6 (12.2) |
|
Ipsilateral axillary node |
0 (0) |
3 (6.1) |
|
Systemic recurrent site |
|
|
0.09 |
Bone |
7 (70.0) |
10 (20.4) |
|
Contralateral breast |
1 (10.0) |
8 (16.3) |
|
Lung |
1 (10.0) |
6 (12.2) |
|
Brain |
0 (0) |
6 (12.2) |
|
Liver |
0 (0) |
5 (10.2) |
|
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Citations
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