Triple-Negative Breast Cancer Is Not 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-conser...
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| Veröffentlicht in: | Annals of surgical oncology 2011-10, Vol.18 (11), p.3164-3173 |
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| creator | Adkins, Farrell C. Gonzalez-Angulo, Ana Maria Lei, Xiudong Hernandez-Aya, Leonel F. Mittendorf, Elizabeth A. Litton, Jennifer K. Wagner, Jamie Hunt, Kelly K. Woodward, Wendy A. Meric-Bernstam, Funda |
| description | 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
|
| doi_str_mv | 10.1245/s10434-011-1920-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4337779</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2583776531</sourcerecordid><originalsourceid>FETCH-LOGICAL-c468t-e90471488ce7f203905ea86e5521c5cc75fb813f19577689f0909619aa4c04f3</originalsourceid><addsrcrecordid>eNp1kU1PGzEQhi1ExVf7A3pBKy6cls547bV9qdRGfEkILrlbxsyGRRs72JtI8OvrEBraSj3ZmnnmnXf0MvYV4Qy5kN8ygmhEDYg1Gg716w47QFkqotW4W_7Q6trwVu6zw5yfAFA1IPfYPkcjlDTygN1NU78YqL6lmRv7FVU_E7k8VhMXPKXqOle3caxcNYlhTK4PD70vXAxVF9OWjSFTWr3VP7NPnRsyfXl_j9j04nw6uapv7i6vJz9ual-8jTUZEAqF1p5Ux6ExIMnplqTk6KX3Snb3GpsOjVSq1aYDA6ZF45zwILrmiH3fyC6W93N68LR2N9hF6ucuvdjoevt3J_SPdhZXVjSNUsoUgdN3gRSfl5RHO--zp2FwgeIyW22ERt6aNXnyD_kUlymU46zhCFxo0AXCDeRTzDlRt7WCYNdZ2U1WtmRl11nZ1zJz_OcN24nf4RSAb4BcWmFG6WPz_1V_AdWun0I</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>921024808</pqid></control><display><type>article</type><title>Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Adkins, Farrell C. ; Gonzalez-Angulo, Ana Maria ; Lei, Xiudong ; Hernandez-Aya, Leonel F. ; Mittendorf, Elizabeth A. ; Litton, Jennifer K. ; Wagner, Jamie ; Hunt, Kelly K. ; Woodward, Wendy A. ; Meric-Bernstam, Funda</creator><creatorcontrib>Adkins, Farrell C. ; Gonzalez-Angulo, Ana Maria ; Lei, Xiudong ; Hernandez-Aya, Leonel F. ; Mittendorf, Elizabeth A. ; Litton, Jennifer K. ; Wagner, Jamie ; Hunt, Kelly K. ; Woodward, Wendy A. ; Meric-Bernstam, Funda</creatorcontrib><description><![CDATA[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.]]></description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-011-1920-z</identifier><identifier>PMID: 21947595</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>American Society of Breast Surgeons ; Breast cancer ; Breast Neoplasms - metabolism ; Breast Neoplasms - surgery ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local - diagnosis ; Neoplasm Recurrence, Local - metabolism ; Neoplasm Recurrence, Local - mortality ; Neoplasm Staging ; Oncology ; Postoperative Complications ; Prospective Studies ; Receptor, ErbB-2 - metabolism ; Receptors, Estrogen - metabolism ; Receptors, Progesterone - metabolism ; Retrospective Studies ; Surgery ; Surgical Oncology ; Survival Rate ; Treatment Outcome</subject><ispartof>Annals of surgical oncology, 2011-10, Vol.18 (11), p.3164-3173</ispartof><rights>Society of Surgical Oncology 2011</rights><rights>Society of Surgical Oncology 2011 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-e90471488ce7f203905ea86e5521c5cc75fb813f19577689f0909619aa4c04f3</citedby><cites>FETCH-LOGICAL-c468t-e90471488ce7f203905ea86e5521c5cc75fb813f19577689f0909619aa4c04f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-011-1920-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-011-1920-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21947595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Adkins, Farrell C.</creatorcontrib><creatorcontrib>Gonzalez-Angulo, Ana Maria</creatorcontrib><creatorcontrib>Lei, Xiudong</creatorcontrib><creatorcontrib>Hernandez-Aya, Leonel F.</creatorcontrib><creatorcontrib>Mittendorf, Elizabeth A.</creatorcontrib><creatorcontrib>Litton, Jennifer K.</creatorcontrib><creatorcontrib>Wagner, Jamie</creatorcontrib><creatorcontrib>Hunt, Kelly K.</creatorcontrib><creatorcontrib>Woodward, Wendy A.</creatorcontrib><creatorcontrib>Meric-Bernstam, Funda</creatorcontrib><title>Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description><![CDATA[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.]]></description><subject>American Society of Breast Surgeons</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - metabolism</subject><subject>Breast Neoplasms - surgery</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Mastectomy</subject><subject>Mastectomy, Segmental</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - diagnosis</subject><subject>Neoplasm Recurrence, Local - metabolism</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Receptor, ErbB-2 - metabolism</subject><subject>Receptors, Estrogen - metabolism</subject><subject>Receptors, Progesterone - metabolism</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1PGzEQhi1ExVf7A3pBKy6cls547bV9qdRGfEkILrlbxsyGRRs72JtI8OvrEBraSj3ZmnnmnXf0MvYV4Qy5kN8ygmhEDYg1Gg716w47QFkqotW4W_7Q6trwVu6zw5yfAFA1IPfYPkcjlDTygN1NU78YqL6lmRv7FVU_E7k8VhMXPKXqOle3caxcNYlhTK4PD70vXAxVF9OWjSFTWr3VP7NPnRsyfXl_j9j04nw6uapv7i6vJz9ual-8jTUZEAqF1p5Ux6ExIMnplqTk6KX3Snb3GpsOjVSq1aYDA6ZF45zwILrmiH3fyC6W93N68LR2N9hF6ucuvdjoevt3J_SPdhZXVjSNUsoUgdN3gRSfl5RHO--zp2FwgeIyW22ERt6aNXnyD_kUlymU46zhCFxo0AXCDeRTzDlRt7WCYNdZ2U1WtmRl11nZ1zJz_OcN24nf4RSAb4BcWmFG6WPz_1V_AdWun0I</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Adkins, Farrell C.</creator><creator>Gonzalez-Angulo, Ana Maria</creator><creator>Lei, Xiudong</creator><creator>Hernandez-Aya, Leonel F.</creator><creator>Mittendorf, Elizabeth A.</creator><creator>Litton, Jennifer K.</creator><creator>Wagner, Jamie</creator><creator>Hunt, Kelly K.</creator><creator>Woodward, Wendy A.</creator><creator>Meric-Bernstam, Funda</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20111001</creationdate><title>Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation</title><author>Adkins, Farrell C. ; Gonzalez-Angulo, Ana Maria ; Lei, Xiudong ; Hernandez-Aya, Leonel F. ; Mittendorf, Elizabeth A. ; Litton, Jennifer K. ; Wagner, Jamie ; Hunt, Kelly K. ; Woodward, Wendy A. ; Meric-Bernstam, Funda</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c468t-e90471488ce7f203905ea86e5521c5cc75fb813f19577689f0909619aa4c04f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>American Society of Breast Surgeons</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - metabolism</topic><topic>Breast Neoplasms - surgery</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Mastectomy</topic><topic>Mastectomy, Segmental</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoplasm Grading</topic><topic>Neoplasm Recurrence, Local - diagnosis</topic><topic>Neoplasm Recurrence, Local - metabolism</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Postoperative Complications</topic><topic>Prospective Studies</topic><topic>Receptor, ErbB-2 - metabolism</topic><topic>Receptors, Estrogen - metabolism</topic><topic>Receptors, Progesterone - metabolism</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adkins, Farrell C.</creatorcontrib><creatorcontrib>Gonzalez-Angulo, Ana Maria</creatorcontrib><creatorcontrib>Lei, Xiudong</creatorcontrib><creatorcontrib>Hernandez-Aya, Leonel F.</creatorcontrib><creatorcontrib>Mittendorf, Elizabeth A.</creatorcontrib><creatorcontrib>Litton, Jennifer K.</creatorcontrib><creatorcontrib>Wagner, Jamie</creatorcontrib><creatorcontrib>Hunt, Kelly K.</creatorcontrib><creatorcontrib>Woodward, Wendy A.</creatorcontrib><creatorcontrib>Meric-Bernstam, Funda</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><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>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adkins, Farrell C.</au><au>Gonzalez-Angulo, Ana Maria</au><au>Lei, Xiudong</au><au>Hernandez-Aya, Leonel F.</au><au>Mittendorf, Elizabeth A.</au><au>Litton, Jennifer K.</au><au>Wagner, Jamie</au><au>Hunt, Kelly K.</au><au>Woodward, Wendy A.</au><au>Meric-Bernstam, Funda</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>18</volume><issue>11</issue><spage>3164</spage><epage>3173</epage><pages>3164-3173</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract><![CDATA[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.]]></abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21947595</pmid><doi>10.1245/s10434-011-1920-z</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2011-10, Vol.18 (11), p.3164-3173 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4337779 |
| source | MEDLINE; SpringerLink Journals |
| subjects | American Society of Breast Surgeons Breast cancer Breast Neoplasms - metabolism Breast Neoplasms - surgery Cohort Studies Female Follow-Up Studies Humans Mastectomy Mastectomy, Segmental Medicine Medicine & Public Health Middle Aged Neoplasm Grading Neoplasm Recurrence, Local - diagnosis Neoplasm Recurrence, Local - metabolism Neoplasm Recurrence, Local - mortality Neoplasm Staging Oncology Postoperative Complications Prospective Studies Receptor, ErbB-2 - metabolism Receptors, Estrogen - metabolism Receptors, Progesterone - metabolism Retrospective Studies Surgery Surgical Oncology Survival Rate Treatment Outcome |
| title | Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation |
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