Hong Yi-Yan, Zhan Hong-Liang, Li Guan-Qiao, Chen Qiu-Yan, Wu San-Gang, Zhang Fu-Xing
Department of General Surgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China.
Department of Breast Surgery, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, People's Republic of China.
J Invest Surg. 2025 Dec;38(1):2550774. doi: 10.1080/08941939.2025.2550774. Epub 2025 Sep 1.
To compare the outcomes between mastectomy (MAST) and breast-conserving surgery (BCS) in patients with metastatic breast cancer (dnMBC).
Patients diagnosed with dnMBC between 2010 and 2020 were retrospectively included. The chi-square test, binomial logistic regression, propensity score matching (PSM), Kaplan-Meier method, and multivariate Cox proportional analysis were used for statistical analyses.
A total of 7880 patients were identified, including 2248 (28.5%) patients who underwent BCS and 5632 (71.5%) had achieved MAST. Although no statistically significant difference was found ( = 0.182), patients receiving MAST had a decreasing trend in later years. There were 74.3% ( = 629) of patients receiving MAST in 2010 and 68.5% ( = 366) in 2020. Younger age, advanced tumor stage, and advanced nodal stage were independent predictors of receiving MAST. There were 466 pairs of patients who were completely matched using PSM. The 3-year breast cancer-specific survival (BCSS) was 72.4% and 73.0% in patients treated with BCS and MAST, respectively ( = 0.509). The 3-year overall survival (OS) was 68.4% and 70.5% in patients treated with BCS and MAST, respectively ( = 0.702). The multivariate prognostic analyses showed that MAST had a similar BCSS ( = 0.996) and OS ( = 0.784) than those in BCS group.
Our study suggests that BCS and MAST yield similar survival outcomes in dnMBC.
比较转移性乳腺癌（dnMBC）患者接受乳房切除术（MAST）和保乳手术（BCS）后的结局。
回顾性纳入2010年至2020年间诊断为dnMBC的患者。采用卡方检验、二项逻辑回归、倾向得分匹配（PSM）、Kaplan-Meier法和多变量Cox比例分析进行统计分析。
共纳入7880例患者，其中2248例（28.5%）接受了BCS，5632例（71.5%）接受了MAST。尽管未发现统计学显著差异（P = 0.182），但接受MAST的患者在后期呈下降趋势。2010年接受MAST的患者为74.3%（n = 629），2020年为68.5%（n = 366）。年龄较小、肿瘤分期较晚和淋巴结分期较晚是接受MAST的独立预测因素。使用PSM完全匹配了466对患者。接受BCS和MAST治疗的患者3年乳腺癌特异性生存率（BCSS）分别为72.4%和73.0%（P = 0.509）。接受BCS和MAST治疗的患者3年总生存率（OS）分别为68.4%和70.5%（P = 0.702）。多变量预后分析显示，MAST的BCSS（P = 0.996）和OS（P = 0.784）与BCS组相似。
我们的研究表明，BCS和MAST在dnMBC患者中产生相似的生存结局。
