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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2011

01-10-2011 | American Society of Breast Surgeons

Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation

Authors: Farrell C. Adkins, MD, Ana Maria Gonzalez-Angulo, MD, Xiudong Lei, PhD, Leonel F. Hernandez-Aya, MD, Elizabeth A. Mittendorf, MD, Jennifer K. Litton, MD, Jamie Wagner, DO, Kelly K. Hunt, MD, Wendy A. Woodward, MD, PhD, Funda Meric-Bernstam, MD

Published in: Annals of Surgical Oncology | Issue 11/2011

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Abstract

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.
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Metadata
Title
Triple-Negative Breast Cancer Is Not a Contraindication for Breast Conservation
Authors
Farrell C. Adkins, MD
Ana Maria Gonzalez-Angulo, MD
Xiudong Lei, PhD
Leonel F. Hernandez-Aya, MD
Elizabeth A. Mittendorf, MD
Jennifer K. Litton, MD
Jamie Wagner, DO
Kelly K. Hunt, MD
Wendy A. Woodward, MD, PhD
Funda Meric-Bernstam, MD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1920-z

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