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Breast-Conservation Therapy after Neoadjuvant Chemotherapy Does Not Compromise 10-year Breast Cancer Specific Mortality
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12-2018
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Source: Am J Clin Oncol. 41(12):1246-1251
[PDF-680.03 KB]
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Alternative Title:Am J Clin Oncol
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Description:Objectives:
Neoadjuvant chemotherapy can increase the rate of breast-conserving surgery by downstaging disease in patients with breast cancer. The aim of this study was to determine whether patients who received neoadjuvant chemotherapy have equal survival after breast-conservation therapy compared to mastectomy.
Methods:
Using the New Jersey State Cancer Registry (NJSCR) patients with a primary breast cancer diagnosed between1998–2003 who underwent neoadjuvant chemotherapy were selected (n=1,468). Of those, only patients who received lumpectomy plus radiation (n=276) or mastectomy without radiation (n=442) were included in the analysis. The main outcome measured included 10-year breast cancer specific mortality, with ninety percent of patients with known vital status through the end of 2011.
Results:
Baseline characteristics did not differ significantly between the breast-conservation and mastectomy without radiation groups except with respect to summary stage and lymph node involvement. After propensity score matching these differences were no longer statistically significant; however, both estrogen and progesterone status achieved statistical significance. The Kaplan-Meier survival curve showed that the breast-conservation group had significantly higher breast cancer specific survival than the mastectomy group (p=0.0046). After adjusting for the propensity score in the regression model, the breast-conservation group continued to show significantly better survival than the mastectomy group (HR=0.46 95% CI 0.27–0.78).
Conclusions:
This study is consistent with previous research showing that breast-conserving surgery after neoadjuvant chemotherapy does not reduce breast cancer-specific survival. In fact, patients undergoing breast-conservation after neoadjuvant therapy appeared to have better survival than patients undergoing mastectomy without radiation.
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Pubmed ID:29782362
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Pubmed Central ID:PMC8077450
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