Breast-conserving surgery vs. total mastectomy in patients with triple negative breast cancer in early stages: A propensity score analysis

Breast Dis. 2020;39(1):29-35. doi: 10.3233/BD-190391.

Abstract

Background: Breast-conserving surgery (BCS) as an alternative to total mastectomy (TM) in patients with early-stage triple-negative breast cancer (TNBC) is not widely spread.

Objective: We aimed to compare the overall survival (OS) and disease-free survival (DFS) between both surgical approaches in early-stage TNBC patients at 10 years.

Methods: We conducted a retrospective cohort study in TNBC female patients with stage I-IIa, treated at a single-center during the period of 2000-2014. We estimated and compared the survival rates with the Kaplan Meier and Long-rank test. Propensity scores were calculated with the generalized boosted regression model and were used in the multivariate Cox regression analysis with the covariate adjustment method.

Results: We included 288 patients, 111 in the BCS vs. 177 in the TM group. The median follow-up was 102 months. Moreover, the patients in the BCS group had superior OS (85% vs. 81%, p = 0.56) and DFS (83% vs. 80%, p = 0.42) at 10 years. In the multivariate Cox analysis, BCS decreased the mortality risk (HR: 0.79, 95% CI: 0.37-1.67, p = 0.538), and the locoregional or distant recurrence risk (HR: 0.67, 95% CI: 0.32-1.41, p = 0.294), albeit with no statistical significance.

Conclusion: BCS is a safe alternative to TM in Latin-American patients with early-stage TNBC.

Keywords: Triple negative breast cancer neoplasm; adjuvant chemotherapy; breast-conserving surgery; overall survival; distant disease-free survival.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Latin America
  • Mastectomy, Segmental*
  • Mastectomy, Simple*
  • Middle Aged
  • Neoplasm Staging
  • Propensity Score
  • Retrospective Studies
  • Treatment Outcome
  • Triple Negative Breast Neoplasms / drug therapy
  • Triple Negative Breast Neoplasms / surgery*