Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Department of Breast Surgery, Mianyang Central Hospital, Mianyang, Sichuan, China.
PLoS One. 2021 Sep 2;16(9):e0256893. doi: 10.1371/journal.pone.0256893. eCollection 2021.
Metaplastic breast cancer (MBC) are rare. The survival outcomes of MBC patients after breast conserving surgery plus radiotherapy (BCS+RT) or mastectomy have not been established. The study aimed to compare survival outcomes of MBC patients subjected to BCS+RT or mastectomy therapeutic options.
Patients who were subjected to BCS+RT or mastectomy between 2004 and 2014 were enrolled in this study through the Surveillance, Epidemiology and End Results (SEER) database. Breast cancer-specific survival (BCSS) and the overall survival (OS) of the participants were determined. Cox proportional hazard model and the Kaplan Meier method were used to determine the correlation between the two surgical methods and survival outcomes.
A total of 1197 patients were enrolled in this study. Among them, 439 patients were subjected to BCS+RT, while 758 patients were subjected to mastectomy. After propensity score matching (PSM), the BCS+RT and mastectomy groups consisted of 321 patients, respectively. The univariate and multivariate analysis with a 6-month landmark all indicate that patients receiving BCS+RT has higher OS than patients receiving mastectomy (HR = 0.701,95% CI = 0.496-0.990, P = 0.044; HR = 0.684,95% CI = 0.479-0.977, P = 0.037) while the BCSS was no difference between the two groups (HR = 0.739,95% CI = 0.474-1.153, P = 0.183; HR = 0.741,95% CI = 0.468-1.173, P = 0.200).
The BCS+RT therapeutic option exhibits a higher OS in MBC patients compared to the mastectomy approach.
化生性乳腺癌（MBC）较为罕见。保乳手术联合放疗（BCS+RT）或乳房切除术治疗MBC 患者的生存结局尚未确定。本研究旨在比较接受 BCS+RT 或乳房切除术治疗的 MBC 患者的生存结局。
本研究通过监测、流行病学和最终结果（SEER）数据库纳入 2004 年至 2014 年间接受 BCS+RT 或乳房切除术的患者。确定参与者的乳腺癌特异性生存（BCSS）和总生存（OS）。采用 Cox 比例风险模型和 Kaplan-Meier 法确定两种手术方法与生存结局的相关性。
本研究共纳入 1197 例患者。其中 439 例接受 BCS+RT，758 例接受乳房切除术。在倾向评分匹配（PSM）后，BCS+RT 组和乳房切除术组分别包含 321 例患者。单因素和多因素分析（6 个月时间标记）均表明，接受 BCS+RT 的患者 OS 高于接受乳房切除术的患者（HR=0.701，95%CI=0.496-0.990，P=0.044；HR=0.684，95%CI=0.479-0.977，P=0.037），而两组的 BCSS 无差异（HR=0.739，95%CI=0.474-1.153，P=0.183；HR=0.741，95%CI=0.468-1.173，P=0.200）。
与乳房切除术相比，BCS+RT 治疗方案可使 MBC 患者的 OS 更高。
