Department of Medical Oncology, Jinling Hospital, School of Medicine, Southern Medical University, Nanjing, China.
Department of Medical Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Clin Breast Cancer. 2019 Dec;19(6):e669-e682. doi: 10.1016/j.clbc.2019.05.011. Epub 2019 May 30.
For early-stage breast cancer, the two current mainstay treatments are breast-conserving therapy (BCT; lumpectomy followed by radiotherapy [RT] and BCT) and mastectomy. Generally, triple-negative breast cancer (TNBC) is more aggressive compared to hormone receptor-positive breast cancer. We sought to investigate the effect of BCT compared to mastectomy on overall survival (OS) and breast cancer-specific survival (BCSS) in T1-2N0M0 TNBC.
A population-based retrospective analysis was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Patients included in the analysis were divided into 3 groups according to surgical modality and RT: BCT, mastectomy alone, and mastectomy with RT. The survival end points were OS and BCSS, and survival analysis was performed by the Kaplan-Meier method and the log-rank test among treatment types.
A total of 14,910 female subjects with T1-2N0M0 TNBC diagnosed between 2010 and 2014 were included. A total of 7381 patients had BCT; 6967 had mastectomy alone, and 562 had mastectomy with RT. Patients treated with BCT had better OS (log-rank P < .05) and BCSS (log-rank P < .05) than those receiving mastectomy with or without RT. The 5-year OS was 88.6% for BCT, 83.0% for mastectomy alone, and 79.6% for mastectomy with RT. The 5-year BCSS was 94.3% for BCT, 93.3% for mastectomy alone, and 83.7% for mastectomy with RT.
In patients with T1-2N0M0 TNBC, BCT was associated with superior OS and BCSS compared to mastectomy with or without RT. After mastectomy, there was no evidence of survival benefit of RT.
对于早期乳腺癌,目前的两种主要治疗方法是保乳治疗(BCT;乳房切除术加放疗[RT]和 BCT)和乳房切除术。一般来说,三阴性乳腺癌(TNBC)比激素受体阳性乳腺癌更具侵袭性。我们试图研究 BCT 与乳房切除术相比,对 T1-2N0M0 TNBC 患者的总生存(OS)和乳腺癌特异性生存(BCSS)的影响。
使用监测、流行病学和最终结果(SEER)数据库进行了一项基于人群的回顾性分析。根据手术方式和 RT 将纳入分析的患者分为 3 组:BCT、单纯乳房切除术和乳房切除术加 RT。生存终点是 OS 和 BCSS,通过 Kaplan-Meier 方法和治疗类型之间的对数秩检验进行生存分析。
共纳入 2010 年至 2014 年间诊断为 T1-2N0M0 TNBC 的 14910 名女性患者。共有 7381 例患者接受 BCT;6967 例患者接受单纯乳房切除术,562 例患者接受乳房切除术加 RT。接受 BCT 治疗的患者 OS(对数秩 P<.05)和 BCSS(对数秩 P<.05)均优于接受乳房切除术加或不加 RT 的患者。BCT 的 5 年 OS 为 88.6%,单纯乳房切除术为 83.0%,乳房切除术加 RT 为 79.6%。BCT 的 5 年 BCSS 为 94.3%,单纯乳房切除术为 93.3%,乳房切除术加 RT 为 83.7%。
在 T1-2N0M0 TNBC 患者中,与乳房切除术加或不加 RT 相比,BCT 与更好的 OS 和 BCSS 相关。乳房切除术后,RT 无生存获益证据。