Breast conserving therapy for central breast cancer in the United States

Abstract

Introduction Although central breast cancer is not a contraindication to breast conserving, most surgeons still choose to perform total mastectomy. The safety of breast conserving treatment for central breast cancer is still unclear. The purpose of this study is to evaluate the long-term survival outcome of central breast cancer. Materials and methods Using SEER database to explore the trend of surgical procedures for patients with central breast cancer. The patients were divided into breast conserving group and non-breast conserving group. Multivariate logistic regression was used to evaluate predictors of breast conserving surgery in central breast cancer. The clinicopathological variables were adjusted through the multivariable Cox risk model, and the stage and T stage were stratified to compare survival results. Results A total of 8702 patients with central breast cancer underwent surgical treatment from 2010 to 2015. There were 3870 patients in the breast conserving group and 4832 patients in the non-breast conserving group. The breast preservation rate was 44.4%, which rose from 39.9% in 2010 to 51% in 2015. Elderly patients (p < 0.001) and low tumor malignancy were predictors of breast conserving therapy. In the 1:1 matched case–control analysis, breast cancer-specific survival (BCSS) (p < 0.001) and overall survival (OS) (p < 0.001) in breast conserving therapy group were still higher than those of non-breast conserving. In the subgroup analysis of T staging and stage, the breast conserving therapy group still had higher OS and BCSS. Conclusion In central breast cancer, breast-conserving therapy is safe and optional.

Survival Outcomes of Breast-Conserving Therapy versus Mastectomy in Early-Stage Breast Cancer, Including Centrally Located Breast Cancer: A SEER-Based Study

“…Our research demonstrated significantly improved OS and BCSS for BCT in both the whole BC cohort and CLBC alone cohort, which was concordant with previous studies [ 14 , 17 , 18 ]. Importantly, we performed the competing risks models, which take into account not only deaths caused by BC but also deaths caused by other events as well as their effects.…”

“…The hesitation of surgeons performing BCT for CLBC patients may be partially due to the special location or anatomic structure of tumors, including the complex lymphatic drainage [ 13 ]. Although a recent retrospective study based on the SEER database discussed the benefit of BCT in CLBC patients, only the classic Cox proportional hazards model was applied, and detailed subgroup analysis was absent [ 14 ]. Zhang's study compared the prognosis of breast-conserving surgery and mastectomy, but the postoperative radiotherapy status was not controlled [ 8 ].…”

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 ]. Information regarding the rate of local recurrence following CL, however, is limited.…”

γ-Glutamyltranspeptidase and pH based “AND” logic gate fluorescent probe for orthotopic breast tumor imaging

“…1,2 Total mastectomy is still the first line of surgical therapy, but the volume of breast tissue removed negatively affects the psychological and physical fitness of patients. 3,4 To reduce both the removed tissue and the chance of recurrence, accurate intraoperative localization of the tumor and its boundary is required. As reported, intraoperative real-time visualization of cancer cells by a logic gate-based fluorescent probe is a highly pursued strategy to achieve that goal.…”