PV QA 4 - Poster Viewing Q&A 4
Purpose/Objective(s): To compare the treatment outcomes of breast conserving surgery plus radiotherapy (BCS+RT) vs. mastectomy for patients with pT1-2N0 triple negative breast cancer (TNBC).
Materials/Methods: 822 patients with pT1-2N0 TNBC treated between 1999 and 2013 were analyzed. All patients underwent BCS+RT (n=158) or mastectomy without radiotherapy (n=664) with negative margins. All patients received adjuvant chemotherapy, mainly with anthrathycline- and/or taxane-based regimens. Survival and recurrence rates were calculated by using the Kaplan-Meier method and compared by log-rank test. Multivariate analysis was performed by Cox model.
Results: The median follow-up time was 69 months for all patients, 66 months for BCT+RT group and 70 months for mastectomy group.The median age was 48 years (range, 22 to 75 years). Compared with mastectomy group, BCT+RT group had more patients with age less than 50 years (74.1% vs. 51.8%, p < 0.001), and T1 tumors (79.1% vs. 48.5%, p<0.001). Other characteristics, including tumor grade, lymphovascular invasion and multiple tumors, were not significantly different between the two groups. The 5-year locoregional recurrence, disease-free, and overall survival rates of BCS+RT group vs. mastectomy group were 7.2% vs. 7.7%, 90.8% vs. 87.0%, and 98.8% vs. 94.5% respectively (p=0.481, p=0.119, and p=0.115). Multivariate analysis confirmed that the differences were not significant (p=0.682, p=0.208, and p=0.121, respectively). T2 tumors, age less than 50 years were independent unfavorable prognostic factors for LRR and DFS.
Conclusion: In pT1-2N0 TNBC, breast conserving surgery plus RT achieved comparable locoregional control, disease-free, and overall survival rates with mastectomy without RT, indicating breast conserving therapy is safe and mastectomy without RT is adequate.
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