BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive subtype shown to have a high risk of locoregional recurrence (LRR). The purpose of this study was to determine the impact of operation type on LRR in TNBC patients. METHODS: A total of 1325 patients with TNBC who underwent breast-conserving therapy (BCT) or mastectomy from 1980 to the present were identified. Clinical and pathological factors were compared by the chi-square test. LRR-free survival (LRRFS), distant metastasis-free survival, and overall survival were estimated by the Kaplan-Meier method. Multivariate analysis was performed by the Cox proportional hazard models. RESULTS: BCT was performed in 651 patients (49%) and mastectomy in 674 (51%). The mastectomy group had larger tumors, a higher incidence of lymphovascular invasion, and higher pathologic N stage (all P < 0.001). At 62-month median follow-up, LRR was seen in 170 (26%) in the BCT group and 203 (30%) in the mastectomy group. Five-year LRRFS rates were higher in the BCT group (76% vs. 71%, P = 0.032), as was distant metastasis-free survival (68% vs. 54%, P < 0.0001) and overall survival (74% vs. 63%, P < 0.0001). On multivariate analysis, T stage (hazard ratio [HR] 1.37, P = 0.006), high nuclear grade (HR 1.92, P = 0.002), lymphovascular invasion (HR 1.93, P < 0.0001), close/positive margins (HR 1.89, P < 0.0001), and use of non-anthracycline or taxane-based adjuvant chemotherapy (HR 2.01, P < 0.0001) increased the LRR risk, while age >50 years was protective (HR 0.73, P = 0.007). Operation type (mastectomy vs. BCT, HR 1.07, P = 0.55) was not statistically significant. CONCLUSIONS: BCT is not associated with increased LRR rates compared to mastectomy. TNBC should not be considered a contraindication for breast conservation.
BACKGROUND: Triple-negative breast cancer (TNBC) is an aggressive subtype shown to have a high risk of locoregional recurrence (LRR). The purpose of this study was to determine the impact of operation type on LRR in TNBC patients. METHODS: A total of 1325 patients with TNBC who underwent breast-conserving therapy (BCT) or mastectomy from 1980 to the present were identified. Clinical and pathological factors were compared by the chi-square test. LRR-free survival (LRRFS), distant metastasis-free survival, and overall survival were estimated by the Kaplan-Meier method. Multivariate analysis was performed by the Cox proportional hazard models. RESULTS: BCT was performed in 651 patients (49%) and mastectomy in 674 (51%). The mastectomy group had larger tumors, a higher incidence of lymphovascular invasion, and higher pathologic N stage (all P < 0.001). At 62-month median follow-up, LRR was seen in 170 (26%) in the BCT group and 203 (30%) in the mastectomy group. Five-year LRRFS rates were higher in the BCT group (76% vs. 71%, P = 0.032), as was distant metastasis-free survival (68% vs. 54%, P < 0.0001) and overall survival (74% vs. 63%, P < 0.0001). On multivariate analysis, T stage (hazard ratio [HR] 1.37, P = 0.006), high nuclear grade (HR 1.92, P = 0.002), lymphovascular invasion (HR 1.93, P < 0.0001), close/positive margins (HR 1.89, P < 0.0001), and use of non-anthracycline or taxane-based adjuvant chemotherapy (HR 2.01, P < 0.0001) increased the LRR risk, while age >50 years was protective (HR 0.73, P = 0.007). Operation type (mastectomy vs. BCT, HR 1.07, P = 0.55) was not statistically significant. CONCLUSIONS: BCT is not associated with increased LRR rates compared to mastectomy. TNBC should not be considered a contraindication for breast conservation.
Authors: M Clarke; R Collins; S Darby; C Davies; P Elphinstone; V Evans; J Godwin; R Gray; C Hicks; S James; E MacKinnon; P McGale; T McHugh; R Peto; C Taylor; Y Wang Journal: Lancet Date: 2005-12-17 Impact factor: 79.321
Authors: J A van Dongen; A C Voogd; I S Fentiman; C Legrand; R J Sylvester; D Tong; E van der Schueren; P A Helle; K van Zijl; H Bartelink Journal: J Natl Cancer Inst Date: 2000-07-19 Impact factor: 13.506
Authors: Leonel F Hernandez-Aya; Mariana Chavez-Macgregor; Xiudong Lei; Funda Meric-Bernstam; Thomas A Buchholz; Limin Hsu; Aysegul A Sahin; Kim-Anh Do; Vicente Valero; Gabriel N Hortobagyi; Ana Maria Gonzalez-Angulo Journal: J Clin Oncol Date: 2011-05-23 Impact factor: 44.544
Authors: C M Perou; T Sørlie; M B Eisen; M van de Rijn; S S Jeffrey; C A Rees; J R Pollack; D T Ross; H Johnsen; L A Akslen; O Fluge; A Pergamenschikov; C Williams; S X Zhu; P E Lønning; A L Børresen-Dale; P O Brown; D Botstein Journal: Nature Date: 2000-08-17 Impact factor: 49.962
Authors: M Overgaard; P S Hansen; J Overgaard; C Rose; M Andersson; F Bach; M Kjaer; C C Gadeberg; H T Mouridsen; M B Jensen; K Zedeler Journal: N Engl J Med Date: 1997-10-02 Impact factor: 91.245
Authors: Matthew M Poggi; David N Danforth; Linda C Sciuto; Sharon L Smith; Seth M Steinberg; David J Liewehr; Cynthia Menard; Marc E Lippman; Allen S Lichter; Rosemary M Altemus Journal: Cancer Date: 2003-08-15 Impact factor: 6.860
Authors: B Fisher; C Redmond; R Poisson; R Margolese; N Wolmark; L Wickerham; E Fisher; M Deutsch; R Caplan; Y Pilch Journal: N Engl J Med Date: 1989-03-30 Impact factor: 91.245
Authors: Javier F Torres-Roca; William J Fulp; Jimmy J Caudell; Nicolas Servant; Marc A Bollet; Marc van de Vijver; Arash O Naghavi; Eleanor E Harris; Steven A Eschrich Journal: Int J Radiat Oncol Biol Phys Date: 2015-06-25 Impact factor: 7.038
Authors: Julia C Radosa; Anne Eaton; Michelle Stempel; Amrin Khander; Cornelia Liedtke; Erich-Franz Solomayer; Maria Karsten; Melissa Pilewskie; Monica Morrow; Tari A King Journal: Ann Surg Oncol Date: 2016-10-25 Impact factor: 5.344
Authors: Meena S Moran; Stuart J Schnitt; Armando E Giuliano; Jay R Harris; Seema A Khan; Janet Horton; Suzanne Klimberg; Mariana Chavez-MacGregor; Gary Freedman; Nehmat Houssami; Peggy L Johnson; Monica Morrow Journal: Int J Radiat Oncol Biol Phys Date: 2014-03-01 Impact factor: 7.038
Authors: A Kümmel; S Kümmel; J Barinoff; F Heitz; J Holtschmidt; W Weikel; F Lorenz-Salehi; A du Bois; P Harter; A Traut; J U Blohmer; B Ataseven Journal: Geburtshilfe Frauenheilkd Date: 2015-07 Impact factor: 2.915
Authors: Zachary S Zumsteg; Monica Morrow; Brittany Arnold; Junting Zheng; Zhigang Zhang; Mark Robson; Tiffany Traina; Beryl McCormick; Simon Powell; Alice Y Ho Journal: Ann Surg Oncol Date: 2013-05-19 Impact factor: 5.344