Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database
Purpose Breast conservation therapy (BCT) is standard for T1–T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors. Methods We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5...
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| Veröffentlicht in: | Breast cancer research and treatment 2019-01, Vol.173 (2), p.301-311 |
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| creator | Mazor, Anna M. Mateo, Alina M. Demora, Lyudmila Sigurdson, Elin R. Handorf, Elizabeth Daly, John M. Aggon, Allison A. Anderson, Penny R. Weiss, Stephanie E. Bleicher, Richard J. |
| description | Purpose
Breast conservation therapy (BCT) is standard for T1–T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors.
Methods
We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5 cm, between 2004 and 2011 who underwent BCT or mastectomy (Mtx) with nodal evaluation. Patients with skin or chest wall involvement were excluded. Patients having clinical T3 tumors were analyzed to determine outcomes based upon presentation, with those having pathologic T3 tumors, subsequently assessed, irrespective of presentation. Overall survival (OS) was analyzed using multivariable Cox proportional hazards models, with adjusted survival curves estimated using inverse probability weighting.
Results
After exclusions, 37,268 patients remained. Median age and tumor size for BCT versus Mtx were 53 versus 54 years (
p
|
| doi_str_mv | 10.1007/s10549-018-5007-4 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6391170</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A575949733</galeid><sourcerecordid>A575949733</sourcerecordid><originalsourceid>FETCH-LOGICAL-c537t-253392eacfb1733927945dc93f56d4a0a6841efa54d049d6a4fd7939818b101a3</originalsourceid><addsrcrecordid>eNp1kstu1DAUhiMEotPCA7BBlti0Eil2bMcxi0pluEoVbMraOnGcGVeJPdjJoNmx5QVY8yw8Ck-C0xk6FIFsyZfznd8-9p9ljwg-JRiLZ5FgzmSOSZXztM7ZnWxGuKC5KIi4m80wKUVeVrg8yA5jvMIYS4Hl_eyAYsoo4-Us-_YiGIgD0t5FE9YwWO_Q2oQ4RtSngNGD7zfIOrRKMeOGiD7bYYkuKap3meB04tHx2c8vX_mP77o_eY7ApQ7dJtqIfIuoeFqU1V6iDb5Hw9Kg99cHQofm1yroJQxQQzQPsnstdNE83I1H2cfXry7nb_OLD2_ezc8vcs2pGPKCUyoLA7qtiZimQjLeaElbXjYMMJQVI6YFzhrMZFMCaxshqaxIVRNMgB5lZ1vd1Vj3ptHpdgE6tQq2h7BRHqy6HXF2qRZ-rUoqCRE4CRzvBIL_NJo4qN5GbboOnPFjVAWhpKAlJSyhT_5Cr_wYUvETVdAiFcCLPbWAzijrWp_O1ZOoOueCSyYTl6jTf1CpNaa36S9Na9P-rQSyTdDBxxhMe1MjwWoyk9qaSSUzqclMarrw4z8f5ybjt3sSUGyBmEJuYcK-ov-r_gLVHtT1</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2123273352</pqid></control><display><type>article</type><title>Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Mazor, Anna M. ; Mateo, Alina M. ; Demora, Lyudmila ; Sigurdson, Elin R. ; Handorf, Elizabeth ; Daly, John M. ; Aggon, Allison A. ; Anderson, Penny R. ; Weiss, Stephanie E. ; Bleicher, Richard J.</creator><creatorcontrib>Mazor, Anna M. ; Mateo, Alina M. ; Demora, Lyudmila ; Sigurdson, Elin R. ; Handorf, Elizabeth ; Daly, John M. ; Aggon, Allison A. ; Anderson, Penny R. ; Weiss, Stephanie E. ; Bleicher, Richard J.</creatorcontrib><description>Purpose
Breast conservation therapy (BCT) is standard for T1–T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors.
Methods
We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5 cm, between 2004 and 2011 who underwent BCT or mastectomy (Mtx) with nodal evaluation. Patients with skin or chest wall involvement were excluded. Patients having clinical T3 tumors were analyzed to determine outcomes based upon presentation, with those having pathologic T3 tumors, subsequently assessed, irrespective of presentation. Overall survival (OS) was analyzed using multivariable Cox proportional hazards models, with adjusted survival curves estimated using inverse probability weighting.
Results
After exclusions, 37,268 patients remained. Median age and tumor size for BCT versus Mtx were 53 versus 54 years (
p
< 0.001) and 6.0 versus 6.7 cm (
p
< 0.001), respectively. Predictors of BCT included age, race, location, facility type, year of diagnosis, tumor size, grade, histology, nodes examined and positive, and administration of chemotherapy and radiotherapy. OS was similar between Mtx and BCT (
p
= 0.36). This held true when neoadjuvant chemotherapy patients were excluded (
p
= 0.39). BCT percentages declined over time (
p
< 0.001), while tumor sizes remained the same (
p
= 0.77). Median follow-up was 51.4 months.
Conclusions
OS for patients with T3 breast cancers is similar whether patients received Mtx or BCT, confirming that tumor size should not be an absolute BCT exclusion. Declining use of BCT for tumors > 5 cm in younger patients may be accounted for by recent trends toward mastectomy.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-018-5007-4</identifier><identifier>PMID: 30343456</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adjuvant chemotherapy ; Adult ; Age Factors ; Aged ; Analysis ; Breast ; Breast - pathology ; Breast - surgery ; Breast cancer ; Breast Neoplasms - mortality ; Breast Neoplasms - pathology ; Breast Neoplasms - therapy ; Cancer patients ; Cancer research ; Chemoradiotherapy, Adjuvant - methods ; Chemotherapy ; Clinical trials ; Databases, Factual - statistics & numerical data ; Female ; Humans ; Mastectomy ; Mastectomy - standards ; Mastectomy - statistics & numerical data ; Mastectomy - trends ; Mastectomy, Segmental - standards ; Mastectomy, Segmental - statistics & numerical data ; Mastectomy, Segmental - trends ; Medicine ; Medicine & Public Health ; Middle Aged ; Neoadjuvant Therapy - methods ; Oncology ; Operating systems (Software) ; Organ Sparing Treatments - standards ; Organ Sparing Treatments - statistics & numerical data ; Organ Sparing Treatments - trends ; Preclinical Study ; Radiation therapy ; Radiotherapy ; Skin ; Surgery ; Survival ; Survival Analysis ; Treatment Outcome ; Tumor Burden ; Tumors ; United States - epidemiology</subject><ispartof>Breast cancer research and treatment, 2019-01, Vol.173 (2), p.301-311</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>COPYRIGHT 2019 Springer</rights><rights>Breast Cancer Research and Treatment is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c537t-253392eacfb1733927945dc93f56d4a0a6841efa54d049d6a4fd7939818b101a3</citedby><cites>FETCH-LOGICAL-c537t-253392eacfb1733927945dc93f56d4a0a6841efa54d049d6a4fd7939818b101a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-018-5007-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-018-5007-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,778,782,883,27911,27912,41475,42544,51306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30343456$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mazor, Anna M.</creatorcontrib><creatorcontrib>Mateo, Alina M.</creatorcontrib><creatorcontrib>Demora, Lyudmila</creatorcontrib><creatorcontrib>Sigurdson, Elin R.</creatorcontrib><creatorcontrib>Handorf, Elizabeth</creatorcontrib><creatorcontrib>Daly, John M.</creatorcontrib><creatorcontrib>Aggon, Allison A.</creatorcontrib><creatorcontrib>Anderson, Penny R.</creatorcontrib><creatorcontrib>Weiss, Stephanie E.</creatorcontrib><creatorcontrib>Bleicher, Richard J.</creatorcontrib><title>Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description>Purpose
Breast conservation therapy (BCT) is standard for T1–T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors.
Methods
We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5 cm, between 2004 and 2011 who underwent BCT or mastectomy (Mtx) with nodal evaluation. Patients with skin or chest wall involvement were excluded. Patients having clinical T3 tumors were analyzed to determine outcomes based upon presentation, with those having pathologic T3 tumors, subsequently assessed, irrespective of presentation. Overall survival (OS) was analyzed using multivariable Cox proportional hazards models, with adjusted survival curves estimated using inverse probability weighting.
Results
After exclusions, 37,268 patients remained. Median age and tumor size for BCT versus Mtx were 53 versus 54 years (
p
< 0.001) and 6.0 versus 6.7 cm (
p
< 0.001), respectively. Predictors of BCT included age, race, location, facility type, year of diagnosis, tumor size, grade, histology, nodes examined and positive, and administration of chemotherapy and radiotherapy. OS was similar between Mtx and BCT (
p
= 0.36). This held true when neoadjuvant chemotherapy patients were excluded (
p
= 0.39). BCT percentages declined over time (
p
< 0.001), while tumor sizes remained the same (
p
= 0.77). Median follow-up was 51.4 months.
Conclusions
OS for patients with T3 breast cancers is similar whether patients received Mtx or BCT, confirming that tumor size should not be an absolute BCT exclusion. Declining use of BCT for tumors > 5 cm in younger patients may be accounted for by recent trends toward mastectomy.</description><subject>Adjuvant chemotherapy</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Analysis</subject><subject>Breast</subject><subject>Breast - pathology</subject><subject>Breast - surgery</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - mortality</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer patients</subject><subject>Cancer research</subject><subject>Chemoradiotherapy, Adjuvant - methods</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Female</subject><subject>Humans</subject><subject>Mastectomy</subject><subject>Mastectomy - standards</subject><subject>Mastectomy - statistics & numerical data</subject><subject>Mastectomy - trends</subject><subject>Mastectomy, Segmental - standards</subject><subject>Mastectomy, Segmental - statistics & numerical data</subject><subject>Mastectomy, Segmental - trends</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy - methods</subject><subject>Oncology</subject><subject>Operating systems (Software)</subject><subject>Organ Sparing Treatments - standards</subject><subject>Organ Sparing Treatments - statistics & numerical data</subject><subject>Organ Sparing Treatments - trends</subject><subject>Preclinical Study</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Skin</subject><subject>Surgery</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kstu1DAUhiMEotPCA7BBlti0Eil2bMcxi0pluEoVbMraOnGcGVeJPdjJoNmx5QVY8yw8Ck-C0xk6FIFsyZfznd8-9p9ljwg-JRiLZ5FgzmSOSZXztM7ZnWxGuKC5KIi4m80wKUVeVrg8yA5jvMIYS4Hl_eyAYsoo4-Us-_YiGIgD0t5FE9YwWO_Q2oQ4RtSngNGD7zfIOrRKMeOGiD7bYYkuKap3meB04tHx2c8vX_mP77o_eY7ApQ7dJtqIfIuoeFqU1V6iDb5Hw9Kg99cHQofm1yroJQxQQzQPsnstdNE83I1H2cfXry7nb_OLD2_ezc8vcs2pGPKCUyoLA7qtiZimQjLeaElbXjYMMJQVI6YFzhrMZFMCaxshqaxIVRNMgB5lZ1vd1Vj3ptHpdgE6tQq2h7BRHqy6HXF2qRZ-rUoqCRE4CRzvBIL_NJo4qN5GbboOnPFjVAWhpKAlJSyhT_5Cr_wYUvETVdAiFcCLPbWAzijrWp_O1ZOoOueCSyYTl6jTf1CpNaa36S9Na9P-rQSyTdDBxxhMe1MjwWoyk9qaSSUzqclMarrw4z8f5ybjt3sSUGyBmEJuYcK-ov-r_gLVHtT1</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Mazor, Anna M.</creator><creator>Mateo, Alina M.</creator><creator>Demora, Lyudmila</creator><creator>Sigurdson, Elin R.</creator><creator>Handorf, Elizabeth</creator><creator>Daly, John M.</creator><creator>Aggon, Allison A.</creator><creator>Anderson, Penny R.</creator><creator>Weiss, Stephanie E.</creator><creator>Bleicher, Richard J.</creator><general>Springer US</general><general>Springer</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>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190101</creationdate><title>Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database</title><author>Mazor, Anna M. ; Mateo, Alina M. ; Demora, Lyudmila ; Sigurdson, Elin R. ; Handorf, Elizabeth ; Daly, John M. ; Aggon, Allison A. ; Anderson, Penny R. ; Weiss, Stephanie E. ; Bleicher, Richard J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c537t-253392eacfb1733927945dc93f56d4a0a6841efa54d049d6a4fd7939818b101a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adjuvant chemotherapy</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Analysis</topic><topic>Breast</topic><topic>Breast - pathology</topic><topic>Breast - surgery</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - mortality</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - therapy</topic><topic>Cancer patients</topic><topic>Cancer research</topic><topic>Chemoradiotherapy, Adjuvant - methods</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Databases, Factual - statistics & numerical data</topic><topic>Female</topic><topic>Humans</topic><topic>Mastectomy</topic><topic>Mastectomy - standards</topic><topic>Mastectomy - statistics & numerical data</topic><topic>Mastectomy - trends</topic><topic>Mastectomy, Segmental - standards</topic><topic>Mastectomy, Segmental - statistics & numerical data</topic><topic>Mastectomy, Segmental - trends</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy - methods</topic><topic>Oncology</topic><topic>Operating systems (Software)</topic><topic>Organ Sparing Treatments - standards</topic><topic>Organ Sparing Treatments - statistics & numerical data</topic><topic>Organ Sparing Treatments - trends</topic><topic>Preclinical Study</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Skin</topic><topic>Surgery</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mazor, Anna M.</creatorcontrib><creatorcontrib>Mateo, Alina M.</creatorcontrib><creatorcontrib>Demora, Lyudmila</creatorcontrib><creatorcontrib>Sigurdson, Elin R.</creatorcontrib><creatorcontrib>Handorf, Elizabeth</creatorcontrib><creatorcontrib>Daly, John M.</creatorcontrib><creatorcontrib>Aggon, Allison A.</creatorcontrib><creatorcontrib>Anderson, Penny R.</creatorcontrib><creatorcontrib>Weiss, Stephanie E.</creatorcontrib><creatorcontrib>Bleicher, Richard J.</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>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</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 Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mazor, Anna M.</au><au>Mateo, Alina M.</au><au>Demora, Lyudmila</au><au>Sigurdson, Elin R.</au><au>Handorf, Elizabeth</au><au>Daly, John M.</au><au>Aggon, Allison A.</au><au>Anderson, Penny R.</au><au>Weiss, Stephanie E.</au><au>Bleicher, Richard J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>173</volume><issue>2</issue><spage>301</spage><epage>311</epage><pages>301-311</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><abstract>Purpose
Breast conservation therapy (BCT) is standard for T1–T2 tumors, but early trials excluded breast cancers > 5 cm. This study was performed to assess patterns and outcomes of BCT for T3 tumors.
Methods
We reviewed the National Cancer Database (NCDB) for noninflammatory breast cancers > 5 cm, between 2004 and 2011 who underwent BCT or mastectomy (Mtx) with nodal evaluation. Patients with skin or chest wall involvement were excluded. Patients having clinical T3 tumors were analyzed to determine outcomes based upon presentation, with those having pathologic T3 tumors, subsequently assessed, irrespective of presentation. Overall survival (OS) was analyzed using multivariable Cox proportional hazards models, with adjusted survival curves estimated using inverse probability weighting.
Results
After exclusions, 37,268 patients remained. Median age and tumor size for BCT versus Mtx were 53 versus 54 years (
p
< 0.001) and 6.0 versus 6.7 cm (
p
< 0.001), respectively. Predictors of BCT included age, race, location, facility type, year of diagnosis, tumor size, grade, histology, nodes examined and positive, and administration of chemotherapy and radiotherapy. OS was similar between Mtx and BCT (
p
= 0.36). This held true when neoadjuvant chemotherapy patients were excluded (
p
= 0.39). BCT percentages declined over time (
p
< 0.001), while tumor sizes remained the same (
p
= 0.77). Median follow-up was 51.4 months.
Conclusions
OS for patients with T3 breast cancers is similar whether patients received Mtx or BCT, confirming that tumor size should not be an absolute BCT exclusion. Declining use of BCT for tumors > 5 cm in younger patients may be accounted for by recent trends toward mastectomy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30343456</pmid><doi>10.1007/s10549-018-5007-4</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Breast cancer research and treatment, 2019-01, Vol.173 (2), p.301-311 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adjuvant chemotherapy Adult Age Factors Aged Analysis Breast Breast - pathology Breast - surgery Breast cancer Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Cancer patients Cancer research Chemoradiotherapy, Adjuvant - methods Chemotherapy Clinical trials Databases, Factual - statistics & numerical data Female Humans Mastectomy Mastectomy - standards Mastectomy - statistics & numerical data Mastectomy - trends Mastectomy, Segmental - standards Mastectomy, Segmental - statistics & numerical data Mastectomy, Segmental - trends Medicine Medicine & Public Health Middle Aged Neoadjuvant Therapy - methods Oncology Operating systems (Software) Organ Sparing Treatments - standards Organ Sparing Treatments - statistics & numerical data Organ Sparing Treatments - trends Preclinical Study Radiation therapy Radiotherapy Skin Surgery Survival Survival Analysis Treatment Outcome Tumor Burden Tumors United States - epidemiology |
| title | Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database |
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