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01-10-2013 | Breast Oncology

Breast-Conserving Therapy Achieves Locoregional Outcomes Comparable to Mastectomy in Women with T1-2N0 Triple-Negative Breast Cancer

Authors: Zachary S. Zumsteg, MD, Monica Morrow, MD, Brittany Arnold, Junting Zheng, MS, Zhigang Zhang, PhD, Mark Robson, MD, Tiffany Traina, MD, Beryl McCormick, MD, Simon Powell, MD, PhD, Alice Y. Ho, MD

Published in: Annals of Surgical Oncology | Issue 11/2013

Abstract

Background

Conflicting data exist regarding optimum local therapy for early-stage triple-negative breast cancer (TNBC). We examined outcomes according to local treatment type in a large cohort of node-negative TNBC patients.

Methods

A total of 1,242 consecutive patients with TNBC treated at a single institution from 1999 to 2008 were identified. Of these, 646 with pathologic stage T1-2N0 TNBC underwent breast-conserving therapy (BCT) (N = 448) or total mastectomy (TM) without postmastectomy radiation (N = 198) and comprised the study population. Locoregional recurrence (LRR), distant metastasis (DM), and overall recurrence were investigated with a competing risk analysis using Gray’s test and multivariable Fine and Gray competing risk regression. Overall survival was assessed using standard Kaplan–Meier methods and a Cox proportional hazards analysis.

Results

Median follow-up was 78.3 months (range 1–156). Eight-one percent of patients received adjuvant chemotherapy. TM patients were younger, were more likely to have lymphovascular invasion, and had larger tumors than patients undergoing BCT (all P ≤ 0.05). The 5-year cumulative incidence of LRR was 4.2 and 5.4 % for patients undergoing BCT and TM, respectively. There was no significant difference in LRR, DM, overall recurrence, disease free survival, or overall survival between groups on univariate analysis, or after adjusting for other variables in multivariate models. Lack of chemotherapy and high tumor stage independently predicted for decreased overall survival (both P < 0.001).

Conclusions

A low, 5-year risk of LRR (4.7 %) was achieved in a large group of women with T1-2N0 TNBC treated with multimodality therapy. BCT was as equally effective as TM for local and distant control.

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Title: Breast-Conserving Therapy Achieves Locoregional Outcomes Comparable to Mastectomy in Women with T1-2N0 Triple-Negative Breast Cancer
Authors: Zachary S. Zumsteg, MD
Monica Morrow, MD
Brittany Arnold
Junting Zheng, MS
Zhigang Zhang, PhD
Mark Robson, MD
Tiffany Traina, MD
Beryl McCormick, MD
Simon Powell, MD, PhD
Alice Y. Ho, MD
Publication date: 01-10-2013
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 11/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-013-3011-9

At a glance: The STEP trials

Springer Medicine

Breast-Conserving Therapy Achieves Locoregional Outcomes Comparable to Mastectomy in Women with T1-2N0 Triple-Negative Breast Cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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