Mary Kathryn Abel1, Case E Brabham2, Ruby Guo2, Kelly Fahrner-Scott3, Jasmine Wong2, Michael Alvarado2, Cheryl Ewing2, Laura J Esserman2, Rita A Mukhtar4. 1. University of California, San Francisco School of Medicine, San Francisco, CA, USA; Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. 2. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. 3. University of California, San Francisco School of Medicine, San Francisco, CA, USA. 4. Department of Surgery, University of California, San Francisco, San Francisco, CA, USA. Electronic address: rita.mukhtar@ucsf.edu.
Abstract
BACKGROUND: The safety of breast conservation therapy (BCT) has not been demonstrated in large ILC tumors, potentially contributing to the higher mastectomy rates seen in ILC. METHODS: We queried a prospectively maintained database to identify patients with ILC measuring ≥4 cm and evaluated difference in recurrence free survival (RFS) between those treated with BCT versus mastectomy using a multivariate model. RESULTS: Of 180 patients, 30 (16.7%) underwent BCT and 150 (83.3%) underwent mastectomy. Patients undergoing mastectomy were younger (56.6 vs. 64.3 years, p = 0.003) and had larger tumors (7.2 vs. 5.4 cm, p < 0.001). While tumor size, nodal stage, receptor subtype, and margin status were significantly associated with RFS, there was no difference in RFS at 5 (p = 0.88) or 10 (p = 0.65) years for individuals undergoing BCT versus mastectomy. CONCLUSIONS: For patients with ILC ≥4 cm, BCT provides similar tumor control as mastectomy, provided that negative margins are achieved. Published by Elsevier Inc.
BACKGROUND: The safety of breast conservation therapy (BCT) has not been demonstrated in large ILC tumors, potentially contributing to the higher mastectomy rates seen in ILC. METHODS: We queried a prospectively maintained database to identify patients with ILC measuring ≥4 cm and evaluated difference in recurrence free survival (RFS) between those treated with BCT versus mastectomy using a multivariate model. RESULTS: Of 180 patients, 30 (16.7%) underwent BCT and 150 (83.3%) underwent mastectomy. Patients undergoing mastectomy were younger (56.6 vs. 64.3 years, p = 0.003) and had larger tumors (7.2 vs. 5.4 cm, p < 0.001). While tumor size, nodal stage, receptor subtype, and margin status were significantly associated with RFS, there was no difference in RFS at 5 (p = 0.88) or 10 (p = 0.65) years for individuals undergoing BCT versus mastectomy. CONCLUSIONS: For patients with ILC ≥4 cm, BCT provides similar tumor control as mastectomy, provided that negative margins are achieved. Published by Elsevier Inc.
Entities:
Keywords:
Breast conservation surgery; Invasive lobular carcinoma; Large tumors; Mastectomy; Recurrence-free survival
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