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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2016

01-12-2016 | Epidemiology

Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients

Authors: M. C. van Maaren, L. de Munck, J. J. Jobsen, P. Poortmans, G. H. de Bock, S. Siesling, L. J. A. Strobbe

Published in: Breast Cancer Research and Treatment | Issue 3/2016

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Abstract

Purpose

Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category.

Methods

All women diagnosed with primary invasive T1-2N2 breast cancer in 2000–2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry. Ten-year OS and DMFS were estimated using multivariable Cox regression. Excess mortality ratios (EMR) were calculated to estimate RS, using life tables of the general population. OS and RS were determined on the whole cohort, and DMFS on the 2003 cohort with completed follow-up. Missing data were imputed.

Results

Of 3071 patients, 1055 (34.4 %) received BCT and 2016 (65.7 %) MAST. BCT and MAST showed equal 10-year OS and RS. After stratification, BCT was significantly associated with improved 10-year OS [HRadjusted 0.82 (95 % CI 0.71–0.96)] and RS (EMRadjusted 0.81 (95 % CI 0.67–0.97]) in T2N2, but not in T1N2. Ten-year DMFS was equal for both treatments [HRadjusted 0.87 (95 % CI 0.64–1.18)] in the 2003 cohort (n = 594), which was representative for the full cohort.

Conclusion

BCT showed at least equal 10-year OS, RS, and DMFS compared to MAST. These results confirm that BCT is a good treatment option in T1-2N2 breast cancer.
Appendix
Available only for authorised users
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Metadata
Title
Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients
Authors
M. C. van Maaren
L. de Munck
J. J. Jobsen
P. Poortmans
G. H. de Bock
S. Siesling
L. J. A. Strobbe
Publication date
01-12-2016
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2016
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-016-4012-8

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