Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer
Background Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM. Methods In t...
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| Veröffentlicht in: | Annals of surgical oncology 2021-09, Vol.28 (9), p.5039-5047 |
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| creator | Kim, Hakyoung Lee, Sae Byul Nam, Seok-Jin Lee, Eun Sook Park, Byeong-Woo Park, Ho Yong Lee, Hyouk Jin Kim, Jisun Chung, Yong Kim, Hee Jeong Ko, Beom Seok Lee, Jong Won Son, Byung Ho Ahn, Sei Hyun |
| description | Background
Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM.
Methods
In this population-based study, we evaluated 45,770 patients from the Korean Breast Cancer Registry (KBCR) who were diagnosed with early breast cancer, and divided them into the BCS + RT and TM groups. To minimize bias caused by factors other than the surgical method, we used exact match pairing of prognostic factors. We compared the 10-year overall survival (OS) and breast cancer-specific survival (BCSS) before and after exact matching. As the KBCR is a multicenter, online-based registry program, we used the Asan Medical Center (AMC) database, a single-center database, to validate the results from the KBCR database.
Results
In both the KBCR and AMC cohorts, the BCS + RT group showed better OS and BCSS than the TM group, before and after exact matching. For the KBCR cohort after exact matching, the hazard ratios for OS and BCSS were 1.541 (95% confidence interval [CI] 1.392–1.707,
p
|
| doi_str_mv | 10.1245/s10434-021-09591-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2480755003</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2480755003</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-cdb8fb16273b3a51d2deaa67efbe2b52cb3654accd9eca4a36ae30343ceace893</originalsourceid><addsrcrecordid>eNp9kUtLxDAUhYMovv-ACwm4cVPNs4-lDr5AUXysw216q5VOMybtYP-90RkVXLhKuPc7J-EcQvY4O-JC6ePAmZIqYYInrNAFT95XyCbXcaTSnK_GO0vzpBCp3iBbIbwyxjPJ9DrZkFIVQiuxSeqHwc-bObTU1fTUI4Q-mbguYJx2zzRun9GP9K4dAr2HqnH9C3qYjXSOPsTZo-uj9ibK0PZuOtKmo2fg23FpRifQWfQ7ZK2GNuDu8twmT-dnj5PL5Pr24mpycp1Ymek-sVWZ1yVPRSZLCZpXokKANMO6RFFqYUuZagXWVgVaUCBTQMmkkhbBYl7IbXK48J159zZg6M20CRbbFjp0QzBC5SzTmjEZ0YM_6KsbfBd_Z4SOaWrNUx0psaCsdyF4rM3MN1Pwo-HMfLZgFi2Y2IL5asG8R9H-0noop1j9SL5jj4BcACGuupjw79v_2H4AJv-VCQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2559155165</pqid></control><display><type>article</type><title>Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer</title><source>SpringerLink Journals - AutoHoldings</source><creator>Kim, Hakyoung ; Lee, Sae Byul ; Nam, Seok-Jin ; Lee, Eun Sook ; Park, Byeong-Woo ; Park, Ho Yong ; Lee, Hyouk Jin ; Kim, Jisun ; Chung, Yong ; Kim, Hee Jeong ; Ko, Beom Seok ; Lee, Jong Won ; Son, Byung Ho ; Ahn, Sei Hyun</creator><creatorcontrib>Kim, Hakyoung ; Lee, Sae Byul ; Nam, Seok-Jin ; Lee, Eun Sook ; Park, Byeong-Woo ; Park, Ho Yong ; Lee, Hyouk Jin ; Kim, Jisun ; Chung, Yong ; Kim, Hee Jeong ; Ko, Beom Seok ; Lee, Jong Won ; Son, Byung Ho ; Ahn, Sei Hyun</creatorcontrib><description>Background
Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM.
Methods
In this population-based study, we evaluated 45,770 patients from the Korean Breast Cancer Registry (KBCR) who were diagnosed with early breast cancer, and divided them into the BCS + RT and TM groups. To minimize bias caused by factors other than the surgical method, we used exact match pairing of prognostic factors. We compared the 10-year overall survival (OS) and breast cancer-specific survival (BCSS) before and after exact matching. As the KBCR is a multicenter, online-based registry program, we used the Asan Medical Center (AMC) database, a single-center database, to validate the results from the KBCR database.
Results
In both the KBCR and AMC cohorts, the BCS + RT group showed better OS and BCSS than the TM group, before and after exact matching. For the KBCR cohort after exact matching, the hazard ratios for OS and BCSS were 1.541 (95% confidence interval [CI] 1.392–1.707,
p
< 0.001) and 1.405 (95% CI 1.183–1.668,
p
< 0.001), respectively, favoring the BCS + RT group. For the AMC cohort after exact matching, the hazard ratios for OS and BCSS were 1.854 (95% CI 1.476–2.328,
p
< 0.001) and 1.807 (95% CI 1.186–2.752,
p
= 0.006), respectively.
Conclusions
Our results suggest that BCS + RT is at least equivalent to TM in terms of OS and may affect treatment decisions in early breast cancer patients.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-021-09591-x</identifier><identifier>PMID: 33492542</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Breast cancer ; Breast Oncology ; Breast surgery ; Lumpectomy ; Mastectomy ; Medical prognosis ; Medicine ; Medicine & Public Health ; Oncology ; Patients ; Population studies ; Radiation therapy ; Surgery ; Surgical Oncology ; Survival</subject><ispartof>Annals of surgical oncology, 2021-09, Vol.28 (9), p.5039-5047</ispartof><rights>Society of Surgical Oncology 2021</rights><rights>Society of Surgical Oncology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-cdb8fb16273b3a51d2deaa67efbe2b52cb3654accd9eca4a36ae30343ceace893</citedby><cites>FETCH-LOGICAL-c375t-cdb8fb16273b3a51d2deaa67efbe2b52cb3654accd9eca4a36ae30343ceace893</cites><orcidid>0000-0002-3370-6937</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-021-09591-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-021-09591-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33492542$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Hakyoung</creatorcontrib><creatorcontrib>Lee, Sae Byul</creatorcontrib><creatorcontrib>Nam, Seok-Jin</creatorcontrib><creatorcontrib>Lee, Eun Sook</creatorcontrib><creatorcontrib>Park, Byeong-Woo</creatorcontrib><creatorcontrib>Park, Ho Yong</creatorcontrib><creatorcontrib>Lee, Hyouk Jin</creatorcontrib><creatorcontrib>Kim, Jisun</creatorcontrib><creatorcontrib>Chung, Yong</creatorcontrib><creatorcontrib>Kim, Hee Jeong</creatorcontrib><creatorcontrib>Ko, Beom Seok</creatorcontrib><creatorcontrib>Lee, Jong Won</creatorcontrib><creatorcontrib>Son, Byung Ho</creatorcontrib><creatorcontrib>Ahn, Sei Hyun</creatorcontrib><title>Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM.
Methods
In this population-based study, we evaluated 45,770 patients from the Korean Breast Cancer Registry (KBCR) who were diagnosed with early breast cancer, and divided them into the BCS + RT and TM groups. To minimize bias caused by factors other than the surgical method, we used exact match pairing of prognostic factors. We compared the 10-year overall survival (OS) and breast cancer-specific survival (BCSS) before and after exact matching. As the KBCR is a multicenter, online-based registry program, we used the Asan Medical Center (AMC) database, a single-center database, to validate the results from the KBCR database.
Results
In both the KBCR and AMC cohorts, the BCS + RT group showed better OS and BCSS than the TM group, before and after exact matching. For the KBCR cohort after exact matching, the hazard ratios for OS and BCSS were 1.541 (95% confidence interval [CI] 1.392–1.707,
p
< 0.001) and 1.405 (95% CI 1.183–1.668,
p
< 0.001), respectively, favoring the BCS + RT group. For the AMC cohort after exact matching, the hazard ratios for OS and BCSS were 1.854 (95% CI 1.476–2.328,
p
< 0.001) and 1.807 (95% CI 1.186–2.752,
p
= 0.006), respectively.
Conclusions
Our results suggest that BCS + RT is at least equivalent to TM in terms of OS and may affect treatment decisions in early breast cancer patients.</description><subject>Breast cancer</subject><subject>Breast Oncology</subject><subject>Breast surgery</subject><subject>Lumpectomy</subject><subject>Mastectomy</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Patients</subject><subject>Population studies</subject><subject>Radiation therapy</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kUtLxDAUhYMovv-ACwm4cVPNs4-lDr5AUXysw216q5VOMybtYP-90RkVXLhKuPc7J-EcQvY4O-JC6ePAmZIqYYInrNAFT95XyCbXcaTSnK_GO0vzpBCp3iBbIbwyxjPJ9DrZkFIVQiuxSeqHwc-bObTU1fTUI4Q-mbguYJx2zzRun9GP9K4dAr2HqnH9C3qYjXSOPsTZo-uj9ibK0PZuOtKmo2fg23FpRifQWfQ7ZK2GNuDu8twmT-dnj5PL5Pr24mpycp1Ymek-sVWZ1yVPRSZLCZpXokKANMO6RFFqYUuZagXWVgVaUCBTQMmkkhbBYl7IbXK48J159zZg6M20CRbbFjp0QzBC5SzTmjEZ0YM_6KsbfBd_Z4SOaWrNUx0psaCsdyF4rM3MN1Pwo-HMfLZgFi2Y2IL5asG8R9H-0noop1j9SL5jj4BcACGuupjw79v_2H4AJv-VCQ</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Kim, Hakyoung</creator><creator>Lee, Sae Byul</creator><creator>Nam, Seok-Jin</creator><creator>Lee, Eun Sook</creator><creator>Park, Byeong-Woo</creator><creator>Park, Ho Yong</creator><creator>Lee, Hyouk Jin</creator><creator>Kim, Jisun</creator><creator>Chung, Yong</creator><creator>Kim, Hee Jeong</creator><creator>Ko, Beom Seok</creator><creator>Lee, Jong Won</creator><creator>Son, Byung Ho</creator><creator>Ahn, Sei Hyun</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3370-6937</orcidid></search><sort><creationdate>20210901</creationdate><title>Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer</title><author>Kim, Hakyoung ; Lee, Sae Byul ; Nam, Seok-Jin ; Lee, Eun Sook ; Park, Byeong-Woo ; Park, Ho Yong ; Lee, Hyouk Jin ; Kim, Jisun ; Chung, Yong ; Kim, Hee Jeong ; Ko, Beom Seok ; Lee, Jong Won ; Son, Byung Ho ; Ahn, Sei Hyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-cdb8fb16273b3a51d2deaa67efbe2b52cb3654accd9eca4a36ae30343ceace893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Breast cancer</topic><topic>Breast Oncology</topic><topic>Breast surgery</topic><topic>Lumpectomy</topic><topic>Mastectomy</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Oncology</topic><topic>Patients</topic><topic>Population studies</topic><topic>Radiation therapy</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Hakyoung</creatorcontrib><creatorcontrib>Lee, Sae Byul</creatorcontrib><creatorcontrib>Nam, Seok-Jin</creatorcontrib><creatorcontrib>Lee, Eun Sook</creatorcontrib><creatorcontrib>Park, Byeong-Woo</creatorcontrib><creatorcontrib>Park, Ho Yong</creatorcontrib><creatorcontrib>Lee, Hyouk Jin</creatorcontrib><creatorcontrib>Kim, Jisun</creatorcontrib><creatorcontrib>Chung, Yong</creatorcontrib><creatorcontrib>Kim, Hee Jeong</creatorcontrib><creatorcontrib>Ko, Beom Seok</creatorcontrib><creatorcontrib>Lee, Jong Won</creatorcontrib><creatorcontrib>Son, Byung Ho</creatorcontrib><creatorcontrib>Ahn, Sei Hyun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Hakyoung</au><au>Lee, Sae Byul</au><au>Nam, Seok-Jin</au><au>Lee, Eun Sook</au><au>Park, Byeong-Woo</au><au>Park, Ho Yong</au><au>Lee, Hyouk Jin</au><au>Kim, Jisun</au><au>Chung, Yong</au><au>Kim, Hee Jeong</au><au>Ko, Beom Seok</au><au>Lee, Jong Won</au><au>Son, Byung Ho</au><au>Ahn, Sei Hyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>28</volume><issue>9</issue><spage>5039</spage><epage>5047</epage><pages>5039-5047</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM.
Methods
In this population-based study, we evaluated 45,770 patients from the Korean Breast Cancer Registry (KBCR) who were diagnosed with early breast cancer, and divided them into the BCS + RT and TM groups. To minimize bias caused by factors other than the surgical method, we used exact match pairing of prognostic factors. We compared the 10-year overall survival (OS) and breast cancer-specific survival (BCSS) before and after exact matching. As the KBCR is a multicenter, online-based registry program, we used the Asan Medical Center (AMC) database, a single-center database, to validate the results from the KBCR database.
Results
In both the KBCR and AMC cohorts, the BCS + RT group showed better OS and BCSS than the TM group, before and after exact matching. For the KBCR cohort after exact matching, the hazard ratios for OS and BCSS were 1.541 (95% confidence interval [CI] 1.392–1.707,
p
< 0.001) and 1.405 (95% CI 1.183–1.668,
p
< 0.001), respectively, favoring the BCS + RT group. For the AMC cohort after exact matching, the hazard ratios for OS and BCSS were 1.854 (95% CI 1.476–2.328,
p
< 0.001) and 1.807 (95% CI 1.186–2.752,
p
= 0.006), respectively.
Conclusions
Our results suggest that BCS + RT is at least equivalent to TM in terms of OS and may affect treatment decisions in early breast cancer patients.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>33492542</pmid><doi>10.1245/s10434-021-09591-x</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3370-6937</orcidid></addata></record> |
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| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2021-09, Vol.28 (9), p.5039-5047 |
| issn | 1068-9265 1534-4681 |
| language | eng |
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| source | SpringerLink Journals - AutoHoldings |
| subjects | Breast cancer Breast Oncology Breast surgery Lumpectomy Mastectomy Medical prognosis Medicine Medicine & Public Health Oncology Patients Population studies Radiation therapy Surgery Surgical Oncology Survival |
| title | Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer |
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