Breast-conserving in centrally located breast cancer patients confirmed safe by SEER based study

Abstract

Background: Due to the lack of high-level data, there is still controversy over the oncological safety of breast conservation in patients with centrally located breast cancer. This study aimed to assess the safety of breast-conserving surgery in patients with centrally located breast cancer based on the data from the Surveillance, Epidemiology, and End Results (SEER) database. Methods:We collected data for all cases diagnosed with breast cancer who underwent breast-conserving surgery from 2012-2014 in the SEER database. The primary outcome of our study was disease-specific survival (DSS) and overall survival (OS). The PSM was used to eliminate the effects of non-random statistics.Chi-square test, Kaplan-Meier method and Cox proportional hazards regression model on univariate and multivariate analysis were used to analyze the data.Results: Data from 79,214 patients who had undergone breast-conserving surgery were analyzed in this study, including those with breast cancer in the central region (n=3,128) and outside the central region (n=76,086). The DSS of central breast cancer patients and outside the central breast cancer patients was 58.1 months versus 58.0 months (P>0.05), respectively, while the OS of the 2 groups was 58.0 months versus 58.0 months (P>0.05), respectively.Conclusions: Breast cancer in the central region should not be contraindicated for breast conserving surgery and breast-conserving surgery can benefit a wider range of patients.

Oncoplastic Breast Conservation for Central Tumors: Definition, Classification, and the Analysis of Single Institution Experience

“…[31][32][33] Despite this, BCS at the central tumor location not only does not worsen but also significantly improves the oncological results of treatment in comparison with mastectomy, while achieving the same results as BCS in cases with other tumor locations. [34][35][36][37][38] Current clinical practice considers BCS as a safe option for central tumors, which is consistent with our experience. However, reconstruction of the central part of the breast can be technically challenging.…”

Comparison of long-term oncologic outcomes of central lumpectomy and conventional breast-conserving surgery for invasive breast cancer: propensity score matching analysis

“…Mastectomy is frequently favored for CLBCs due to concern for oncologic safety and apprehensions regarding unsatisfactory cosmetic outcomes following CL [ 13 ]. Recent studies, however, have reported the safety of BCS for CLBC and introduced several surgical techniques [ 6 , 7 , 14 , 15 ]. In addition, with the development of NAC reconstruction methods, the disadvantages of CL can be reduced [ 16 ].…”

“…Several studies have investigated the survival of patients undergoing CL [ 6 , 7 ]. A recent study using the SEER database reported a comparable overall survival rate of BCS for CLBC compared to mastectomy [ 7 ].…”

“…Another SEER study compared the oncologic safety of BCS for CLBC with that of BCS for non-CLBC and showed comparable oncologic outcomes in terms of 5-year local recurrence-free survival. The analysis, however, was confined to stage I and II breast cancers [ 6 ]. Recently, neoadjuvant chemotherapy has led to an increased rate of BCS [ 8 ], suggesting that more advanced-stage patients are eligible for CL.…”