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This is a retrospective propensity score-matched analysis of a large institutional cohort of patients in order to compare long-term outcomes and clinicopathologic characteristics between patients treated with breast conserving surgery or mastectomy for breast cancer.
The aim of the study is to compare long-term outcomes and clinicopathologic characteristics between patients treated with breast conserving surgery + whole breast irradiation or mastectomy for breast cancer.
Recent observations regarding long-term outcomes among patients with early-stage breast cancer who underwent breast-conserving surgery plus whole-breast irradiation or mastectomy are from a small number of registry-based studies.
Therefore, these findings may overestimate differences in survival between the two groups, compared with randomized controlled trials conducted in the 1980s.
This study performed a propensity score-matched analysis in a cohort of 9710 patients aged <70 years who underwent breast conserving surgery + whole breast irradiation or mastectomy without external radiotherapy for a first primary breast cancer (pT1-2, N0-3a) at the European Institute of Oncology between 2000 and 2008.
Patients were matched by propensity score.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Breast-conserving surgery | Patients who underwent breast-conserving surgery plus whole-breast irradiation |
| |
| Mastectomy | Patients who underwent mastectomy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Breast-conserving surgery | Procedure | Breast conserving surgery plus whole breast irradiation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cumulative incidence of ipsilateral breast tumor recurrence | Incidence of ipsilateral breast tumor recurrence in breast conserving surgery group compared to mastectomy group | 10 years |
| Cumulative incidence of axillary lymph node recurrence | cumulative incidence of axillary lymph node recurrence in breast conserving surgery group compared to mastectomy group | 10 years |
| Cumulative incidence of contralateral breast cancer | Cumulative incidence of contralateral breast cancer in breast conserving surgery group compared to mastectomy group | 10 years |
| Rate of distant metastasis | Incidence of distant metastasis in breast conserving surgery group compared to mastectomy group | 10 years |
| Cumulative incidence of breast cancer specific survival | Cumulative incidence of breast cancer specific survival in breast conserving surgery group compared to mastectomy group | 10 years |
| Rate of overall survival | Incidence of survival in breast conserving surgery group compared to mastectomy group | 10 years |
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Inclusion Criteria:
Exclusion Criteria:
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Retrospectively analysis of patients who received treatment for invasive breast cancer at the European Institute of Oncology between January 1, 2000, and December 31, 2008.
The original cohort comprised 9710 eligible patients with breast cancer, of whom 2289 (23.6%) underwent breast conserving surgery + whole breast irradiation and 7421 (76.4%) underwent mastectomy alone.
After propensity score matching, 1970 of the 2289 patients who underwent mastectomy (86.1%) were successfully matched to 1970 patients who underwent breast conserving surgery.
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| Name | Affiliation | Role |
|---|---|---|
| Francesca Magnoni, MD | European Institute of Oncology | Principal Investigator |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D015412 | Mastectomy, Segmental |
| D008408 | Mastectomy |
| ID | Term |
|---|---|
| D013514 | Surgical Procedures, Operative |
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| Mastectomy | Procedure | Breast mastectomy |
|
| D017437 |
| Skin and Connective Tissue Diseases |