Díaz-Casas Sandra E, Rosero-Díazdel Castillo Flavio J, Mendoza-Díaz Sara, Sáenz-Ladino Andersson, Sánchez-Pedraza Ricardo, Silva-Cárdenas Sonia P, Zuluaga-Liberato Andrea, Briceño-Morales Ximena, Guzmán-AbiSaab Luis, Gamboa-Garay Óscar, Ángel-Aristizábal Javier, Mariño-Lozano Iván, Suárez-Rodríguez Raúl, García-Mora Mauricio, Duarte-Torres Carlos, Núñez-Lemus Marcela
Functional Unit for Breast and Soft Tissue Tumors, Instituto Nacional de Cancerología, Bogotá 111511, Colombia.
Fundación Universitaria de Ciencias de la Salud, Bogotá 111411, Colombia.
Cancers (Basel). 2025 Mar 28;17(7):1131. doi: 10.3390/cancers17071131.
Breast-conserving surgery (BCS) is one of the major surgical advances in breast cancer treatment. This study evaluated the oncological outcomes of BCS in patients with non-metastatic breast cancer at a referral cancer center in a medium-resource country between 2013 and 2019. An observational, analytical, retrospective cohort study was conducted on patients with stage I-IIIC breast cancer treated at the Instituto Nacional de Cancerología (Bogotá, Colombia) from September 2013 to March 2019. Demographic data, tumor characteristics, treatment types, and survival outcomes were retrospectively collected. A total of 409 patients were included. In 64.1% of cases, BCS was performed as the initial treatment and in 35.9%, after neoadjuvant chemotherapy (NACT). With a median follow-up of 85.2 months, tumor recurrence was documented in 9.04% of patients, local recurrence in 2.9%, regional in 2.2%, and distant in 5.6%. The identified risk factors for mortality were a locally advanced clinical stage (HR 5.13; = 0.01), triple-negative subtype (HR 8.02; < 0.01), and nodal involvement of more than four lymph nodes in the surgical specimen (HR 4.00; < 0.01). Breast-conserving surgery is an oncologically safe procedure for patients with early and locally advanced breast cancer who respond to NACT. The time to recurrence and overall survival are determined by the clinical stage, axillary tumor burden, and biological subtype of the disease.
保乳手术（BCS）是乳腺癌治疗领域的一项重大手术进展。本研究评估了2013年至2019年期间，在一个中等资源国家的转诊癌症中心，保乳手术对非转移性乳腺癌患者的肿瘤学结局。对2013年9月至2019年3月在哥伦比亚波哥大国家癌症研究所接受治疗的I-IIIC期乳腺癌患者进行了一项观察性、分析性、回顾性队列研究。回顾性收集了人口统计学数据、肿瘤特征、治疗类型和生存结局。共纳入409例患者。在64.1%的病例中，保乳手术作为初始治疗，35.9%的病例在新辅助化疗（NACT）后进行。中位随访85.2个月，9.04%的患者记录有肿瘤复发，局部复发率为2.9%，区域复发率为2.2%，远处复发率为5.6%。确定的死亡风险因素为局部晚期临床分期（HR 5.13；P = 0.01）、三阴性亚型（HR 8.02；P < 0.01）以及手术标本中淋巴结受累超过四个（HR 4.00；P < 0.01）。对于对新辅助化疗有反应的早期和局部晚期乳腺癌患者，保乳手术是一种肿瘤学上安全的手术。复发时间和总生存期由疾病的临床分期、腋窝肿瘤负荷和生物学亚型决定。
