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Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database.
Mazor, Anna M; Mateo, Alina M; Demora, Lyudmila; Sigurdson, Elin R; Handorf, Elizabeth; Daly, John M; Aggon, Allison A; Anderson, Penny R; Weiss, Stephanie E; Bleicher, Richard J.
Afiliación
  • Mazor AM; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA.
  • Mateo AM; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA.
  • Demora L; Department of Biostatistics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
  • Sigurdson ER; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA.
  • Handorf E; Department of Biostatistics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
  • Daly JM; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA.
  • Aggon AA; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA.
  • Anderson PR; Departments of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
  • Weiss SE; Departments of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
  • Bleicher RJ; Department of Surgical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Room C-308, Philadelphia, PA, 19111, USA. richard.bleicher@fccc.edu.
Breast Cancer Res Treat ; 173(2): 301-311, 2019 Jan.
Article en En | MEDLINE | ID: mdl-30343456
PURPOSE: Breast conservation therapy (BCT) is standard for T1-T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors. METHODS: We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5 cm, between 2004 and 2011 who underwent BCT or mastectomy (Mtx) with nodal evaluation. Patients with skin or chest wall involvement were excluded. Patients having clinical T3 tumors were analyzed to determine outcomes based upon presentation, with those having pathologic T3 tumors, subsequently assessed, irrespective of presentation. Overall survival (OS) was analyzed using multivariable Cox proportional hazards models, with adjusted survival curves estimated using inverse probability weighting. RESULTS: After exclusions, 37,268 patients remained. Median age and tumor size for BCT versus Mtx were 53 versus 54 years (p < 0.001) and 6.0 versus 6.7 cm (p < 0.001), respectively. Predictors of BCT included age, race, location, facility type, year of diagnosis, tumor size, grade, histology, nodes examined and positive, and administration of chemotherapy and radiotherapy. OS was similar between Mtx and BCT (p = 0.36). This held true when neoadjuvant chemotherapy patients were excluded (p = 0.39). BCT percentages declined over time (p < 0.001), while tumor sizes remained the same (p = 0.77). Median follow-up was 51.4 months. CONCLUSIONS: OS for patients with T3 breast cancers is similar whether patients received Mtx or BCT, confirming that tumor size should not be an absolute BCT exclusion. Declining use of BCT for tumors > 5 cm in younger patients may be accounted for by recent trends toward mastectomy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Mastectomía Segmentaria / Bases de Datos Factuales / Tratamientos Conservadores del Órgano / Mastectomía Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Breast Cancer Res Treat Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Mastectomía Segmentaria / Bases de Datos Factuales / Tratamientos Conservadores del Órgano / Mastectomía Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Breast Cancer Res Treat Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos