Fang Min, Zhang Xiaoxi, Zhang Hao, Wu Kainan, Yu Yue, Sheng Yuan
Department of Breast and Thyroid Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Breast Care (Basel). 2019 Aug;14(4):188-193. doi: 10.1159/000499439. Epub 2019 May 7.
Breast conservation therapy (BCT) for female patients with multifocal or multicentric (MF/MC) breast cancer remains controversial. The purpose of the present meta-analysis was to explore whether BCT was feasible for female patients with MF/MC breast cancer and to compare the results of treatment with those of female patients with unifocal breast cancer who underwent BCT and female patients with MF/MC breast cancer who underwent mastectomy.
Online databases, including PubMed and Embase, were independently searched from inception to January 2018 and reviewed by two authors. The present meta-analysis compared local relapse (LR) of BCT versus mastectomy for patients with MF/MC breast cancer and LR of patients with unifocal breast cancer versus patients with MF/MC breast cancer who underwent BCT. Ten studies comprising 19,272 patients were included.
The cumulative incidence of LR was 5.6% (65/1,163) for MF/MC disease treated with BCT, 4.2% (750/17,656) for unifocal disease treated with BCT, and 2.0% (9/453) for MF/MC disease treated with mastectomy. Thus, the cumulative incidence of LR for MF/MC patients treated with BCT was significantly higher than for mastectomy ( < 0.001). However, the forest plot analysis showed no significant differences in LR between BCT and mastectomy procedures (OR = 1.22, 95% CI = 0.49-3.00, = 0.67, = 0%). Compared with the unifocal group treated with BCT, BCT for MF/MC breast cancer showed a significant difference in LR (OR = 2.25, 95% CI = 1.48-3.42, = 0.0001, = 0%).
The LR of BCT for patients with MF/MC breast cancer was higher than that of BCT for patients with unifocal breast cancer. However, no significant difference was found in the incidence of LR between the BCT group and the mastectomy group in patients with MF/MC breast cancer.
对于患有多灶性或多中心性（MF/MC）乳腺癌的女性患者，保乳治疗（BCT）仍存在争议。本荟萃分析的目的是探讨BCT对于患有MF/MC乳腺癌的女性患者是否可行，并将其治疗结果与接受BCT的单灶性乳腺癌女性患者以及接受乳房切除术的MF/MC乳腺癌女性患者的结果进行比较。
从数据库建立至2018年1月，独立检索在线数据库，包括PubMed和Embase，并由两位作者进行综述。本荟萃分析比较了MF/MC乳腺癌患者接受BCT与乳房切除术的局部复发（LR）情况，以及单灶性乳腺癌患者与接受BCT的MF/MC乳腺癌患者的LR情况。纳入了10项研究，共19272例患者。
接受BCT治疗的MF/MC疾病患者的LR累积发生率为5.6%（65/1163），接受BCT治疗的单灶性疾病患者为4.2%（750/17656），接受乳房切除术的MF/MC疾病患者为2.0%（9/453）。因此，接受BCT治疗的MF/MC患者的LR累积发生率显著高于乳房切除术（<0.001）。然而，森林图分析显示BCT和乳房切除术之间的LR无显著差异（OR = 1.22，95%CI = 0.49 - 3.00， = 0.67， = 0%）。与接受BCT的单灶性组相比，MF/MC乳腺癌接受BCT在LR方面存在显著差异（OR = 2.25，95%CI = 1.48 - 3.42， = 0.0001， = 0%）。
MF/MC乳腺癌患者接受BCT的LR高于单灶性乳腺癌患者接受BCT的LR。然而，MF/MC乳腺癌患者中，BCT组和乳房切除组之间的LR发生率未发现显著差异。
