Effect of Breast Conservation Therapy vs Mastectomy on Disease-Specific Survival for Early-Stage Breast Cancer

Agarwal, Shailesh; Pappas, Lisa M.; Neumayer, Leigh; Kokeny, Kristine E.; Agarwal, Jayant P.

doi:10.1001/jamasurg.2013.3049

Cited by 326 publications

(293 citation statements)

References 14 publications

Supporting

Mentioning

260

Contrasting

Unclassified

Order By: Relevance

“…There is now recent data to suggest that BCT may confer a higher breast cancer-specific survival rate compared with mastectomy (Agarwal et al, 2014). Although the reasons behind this observation have yet to be clearly elucidated, this new information elevates the role of BCT in women with early breast cancer.…”

Section: Discussionmentioning

confidence: 95%

“…This study was undertaken to evaluate the validity of this syllogism, and if utilisation of BCT in Asian women can be improved. If possible, higher rates of breast conservation could lead to better survival outcomes in Asian women (Agarwal et al, 2014).…”

Section: Evaluation Of Eligibility and Utilization Of Breast Conservamentioning

confidence: 99%

“…In the light of this new data, one could consider BCT as the preferred modality of surgical treatment for breast cancer when eligibility criteria are fulfilled. In Western countries, BCT rates are often reported to be in excess of 60% (Table 1) (Lee et al, 2009;McGuire et al, 2009;Garcia-Etienne et al, 2012;Agarwal et al, 2014). This is in contrast to…”

Section: Introductionmentioning

confidence: 98%

“…However, a recent study suggests that BCT may be associated with a higher breast cancer specific survival rated than mastectomy or mastectomy with radiation (Agarwal et al, 2014). In the light of this new data, one could consider BCT as the preferred modality of surgical treatment for breast cancer when eligibility criteria are fulfilled.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context

Tan¹,

Sitoh²,

Sim³

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 95%

Section: Evaluation Of Eligibility and Utilization Of Breast Conservamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context

Tan¹,

Sitoh²,

Sim³

2014

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

“…Ogawa et al [9] emphasized that BCT has become the standard strategy for breast cancer surgery ensuring local control with acceptable cosmetic results. Agarwal et al [10] reported that patients who underwent BCT had a higher breast cancer-specific survival rate compared with those treated with mastectomy for early-stage invasive ductal carcinoma.…”

Section: Introductionmentioning

confidence: 99%

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

Elzawawy

Kelada

Alkarmouty

2016

European Journal of Surgical Oncology (EJSO)

View full text Add to dashboard Cite

Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

show abstract

Use of and Mortality After Bilateral Mastectomy Compared With Other Surgical Treatments for Breast Cancer in California, 1998-2011

Kurian

Lichtensztajn

Keegan

et al. 2014

JAMA

242

191

View full text Add to dashboard Cite

IMPORTANCE Bilateral mastectomy is increasingly used to treat unilateral breast cancer. Because it may have medical and psychosocial complications, a better understanding of its use and outcomes is essential to optimizing cancer care. OBJECTIVE To compare use of and mortality after bilateral mastectomy, breast-conserving therapy with radiation, and unilateral mastectomy. DESIGN, SETTING, AND PARTICIPANTS Observational cohort study within the population-based California Cancer Registry; participants were women diagnosed with stages 0–III unilateral breast cancer in California from 1998 through 2011, with median follow-up of 89.1 months. MAIN OUTCOMES AND MEASURES Factors associated with surgery use (from polytomous logistic regression); overall and breast cancer–specific mortality (from propensity score weighting and Cox proportional hazards analysis). RESULTS Among 189 734 patients, the rate of bilateral mastectomy increased from 2.0% (95% CI, 1.7%–2.2%) in 1998 to 12.3% (95% CI, 11.8%–12.9%) in 2011, an annual increase of 14.3% (95% CI, 13.1%–15.5%); among women younger than 40 years, the rate increased from 3.6% (95% CI, 2.3%–5.0%) in 1998 to 33% (95% CI, 29.8%–36.5%) in 2011. Bilateral mastectomy was more often used by non-Hispanic white women, those with private insurance, and those who received care at a National Cancer Institute (NCI)–designated cancer center (8.6% [95% CI, 8.1%–9.2%] among NCI cancer center patients vs 6.0% [95% CI, 5.9%–6.1%] among non-NCI cancer center patients; odds ratio [OR], 1.13 [95% CI, 1.04–1.22]); in contrast, unilateral mastectomy was more often used by racial/ethnic minorities (Filipina, 52.8% [95% CI, 51.6%–54.0%]; OR, 2.00 [95% CI, 1.90–2.11] and Hispanic, 45.6% [95% CI, 45.0%–46.2%]; OR, 1.16 [95% CI, 1.13–1.20] vs non-Hispanic white, 35.2% [95% CI, 34.9%–35.5%]) and those with public/Medicaid insurance (48.4% [95% CI, 47.8%–48.9%]; OR, 1.08 [95% CI, 1.05–1.11] vs private insurance, 36.6% [95% CI, 36.3%–36.8%]). Compared with breast-conserving surgery with radiation (10-year mortality, 16.8% [95% CI, 16.6%–17.1%]), unilateral mastectomy was associated with higher all-cause mortality (hazard ratio [HR], 1.35 [95% CI, 1.32–1.39]; 10-year mortality, 20.1% [95% CI, 19.9%–20.4%]). There was no significant mortality difference compared with bilateral mastectomy (HR, 1.02 [95% CI, 0.94–1.11]; 10-year mortality, 18.8% [95% CI, 18.6%–19.0%]). Propensity analysis showed similar results. CONCLUSIONS AND RELEVANCE Use of bilateral mastectomy increased significantly throughout California from 1998 through 2011 and was not associated with lower mortality than that achieved with breast-conserving surgery plus radiation. Unilateral mastectomy was associated with higher mortality than were the other 2 surgical options.

show abstract

Effect of Breast Conservation Therapy vs Mastectomy on Disease-Specific Survival for Early-Stage Breast Cancer

Abstract: Patients who underwent BCT have a higher breast cancer-specific survival rate compared with those treated with mastectomy alone or mastectomy with radiation for early-stage invasive ductal carcinoma. Further investigation is warranted to understand what may be contributing to this effect.

Cited by 326 publications

References 14 publications

Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context

Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context

New possible surgical approaches for the submammary adipofascial flap based on its arterial supply

Use of and Mortality After Bilateral Mastectomy Compared With Other Surgical Treatments for Breast Cancer in California, 1998-2011

Contact Info

Product

Resources

About