Breast Conservation Therapy Versus Mastectomy in Patients with T1-2N1 Triple-Negative Breast Cancer: Pooled Analysis of KROG 14-18 and 14-23

Cancer Res Treat. 2018 Oct;50(4):1316-1323. doi: 10.4143/crt.2017.575. Epub 2018 Jan 8.

Abstract

Purpose: The aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) versus mastectomy for patients with pT1-2N1 triple-negative breast cancer (TNBC).

Materials and methods: Using two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) receivedwhole breast RTwith orwithoutregional nodal RT,while nonewho underwent mastectomy (n=108)received it. All patients received taxane-based adjuvant chemotherapy. The median follow-up periods were 65 months in the BCS+RT group, and 74 months in the mastectomy group.

Results: The median age of all patients was 48 years (range, 24 to 70 years). Mastectomy group had more patients with multiple tumors (p < 0.001), no lymphovascular invasion (p=0.001), higher number of involved lymph node (p=0.028), and higher nodal ratio ≥ 0.2 (p=0.037). Other characteristics were not significantly different between the two groups. The 5-year locoregionalrecurrence-free, disease-free, and overall survivalrates of BCS+RT group versus mastectomy group were 94.6% versus 87.7%, 89.5% versus 80.4%, and 95.0% versus 87.8%, respectively, and the differences were statistically significant after adjusting for covariates (p=0.010, p=0.006, and p=0.005, respectively).

Conclusion: In pT1-2N1 TNBC, breast conservation therapy achieved better locoregional recurrencefree, disease-free, and overall survival rates compared with mastectomy.

Keywords: Breast conservation therapy; Mastectomy; Triple negative breast neoplasms.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Chemotherapy, Adjuvant
  • Female
  • Humans
  • Mastectomy / methods*
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy, Adjuvant / methods
  • Retrospective Studies
  • Survival Analysis
  • Taxoids / therapeutic use
  • Treatment Outcome
  • Triple Negative Breast Neoplasms / pathology*
  • Triple Negative Breast Neoplasms / therapy*

Substances

  • Taxoids