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年轻乳腺癌女性的局部复发:保乳治疗与单纯乳房切除术对比

Local Recurrence in Young Women with Breast Cancer: Breast Conserving Therapy vs. Mastectomy Alone.

作者信息

Nguyen Dang Van, Kim Sang-Won, Oh Young-Taek, Noh O Kyu, Jung Yongsik, Chun Mison, Yoon Dae Sung

机构信息

Department of Oncology, Hanoi Medical University, Hanoi 116001, Vietnam.

Department of Radiation Oncology, Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Korea.

出版信息

Cancers (Basel). 2021 Apr 29;13(9):2150. doi: 10.3390/cancers13092150.

Abstract

We compared the cumulative incidence of local recurrence in young patients (≤40 years) with breast cancer between breast conserving therapy (BCT) and mastectomy alone. Among 428 women with early-stage breast cancer who were treated between 2001 and 2012, 311 underwent BCT and 117 underwent mastectomy alone. Adjuvant systemic treatments were administered to 409 patients (95.6%). We compared the cumulative incidence of LR and survival rates between two groups. During a median follow-up period of 91 months, the 10-year cumulative incidence of LR was 9.3% (median interval of 36.5 months from surgery). Patients treated with BCT tended to have a higher risk for local recurrence (11.1% for BCT vs. 4.1% for mastectomy alone, = 0.078). All patients with isolated LR after BCT ( = 23) underwent salvage mastectomy followed by systemic treatments. The 5-year distant metastasis-free survival and overall survival of patients with isolated LR after BCT were 44.2% and 82.2%, respectively. The BCT group exhibited an approximately 2.5-fold higher risk of LR than mastectomy alone group. Patients with isolated LR after BCT showed poor prognosis despite undergoing aggressive salvage treatments. The development of novel treatments should be investigated to reduce LR for improving prognosis and preserving cosmetic outcomes in young women.

摘要

我们比较了保乳治疗(BCT)和单纯乳房切除术治疗的年轻(≤40岁)乳腺癌患者局部复发的累积发生率。在2001年至2012年接受治疗的428例早期乳腺癌女性中,311例行BCT,117例仅行乳房切除术。409例患者(95.6%)接受了辅助全身治疗。我们比较了两组之间局部复发的累积发生率和生存率。在中位随访期91个月期间,局部复发的10年累积发生率为9.3%(从手术开始的中位间隔时间为36.5个月)。接受BCT治疗的患者局部复发风险往往更高(BCT组为11.1%,单纯乳房切除术组为4.1%,P = 0.078)。所有BCT后发生孤立性局部复发的患者(n = 23)均接受了挽救性乳房切除术后再进行全身治疗。BCT后发生孤立性局部复发的患者5年无远处转移生存率和总生存率分别为44.2%和82.2%。BCT组的局部复发风险比单纯乳房切除术组高约2.5倍。BCT后发生孤立性局部复发的患者尽管接受了积极的挽救性治疗,但预后较差。应研究新的治疗方法以降低局部复发率,从而改善年轻女性的预后并保留美容效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20b3/8124780/759dd51d591d/cancers-13-02150-g001.jpg

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