期刊
FRONTIERS IN ONCOLOGY
卷 11, 期 -, 页码 -出版社
FRONTIERS MEDIA SA
DOI: 10.3389/fonc.2021.666316
关键词
breast cancer; breast-conserving surgery; mastectomy; breast reconstruction; survival
类别
资金
- National Natural Science Foundation of China [81871513]
- Science and Technology Planning Project of Guangzhou City [202002030236]
- Science and Technology Special Fund of Guangdong Provincial People's Hospital [Y012018218]
- CSCO-Hengrui Cancer Research Fund [Y-HR2016-067]
- Guangdong Provincial Department of Education Characteristic Innovation Project [2015KTSCX080]
- Fundamental Research Funds for the Central Universities [2020ZYGXZR017]
- Guangdong Basic and Applied Basic Research Foundation [2020A1515010346]
The study found that breast-conserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR) have better survival outcomes compared to mastectomy in young women with operable breast cancer, and marital status can affect the impact of surgical approaches on survival outcomes.
Background The influence of surgical approaches [including mastectomy, breast-conserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR) on prognosis of young women (<40 years old) with operable breast cancer has not been determined yet, and this might vary in patients with different marital statuses. Therefore, we aimed to investigate the effect of surgery on survival outcomes for young women with operable breast cancer in different marital statuses. Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to identify young women with operable breast cancer between 2004 and 2016, who underwent mastectomy, BCT or PMBR. We assessed overall survival (OS) and breast cancer-specific survival (BCSS) using the Kaplan-Meier method and hazard ratios using multivariate Cox proportional hazard regression. Results Compared to mastectomy, both of BCT and PMBR conferred better OS (BCT: HR = 0.79, 95%CI: 0.69-0.90, p <0.001; PMBR: HR = 0.70, 95%CI: 0.63-0.78, p <0.001) and BCSS (BCT: HR = 0.79, 95%CI: 0.69-0.91, p = 0.001; PMBR: HR = 0.73, 95%CI: 0.65-0.81, p <0.001), but there was no significant difference of survival between BCT and PMBR group. The survival benefit of BCT compared to mastectomy remained significant in unmarried young women (OS: HR = 0.68, 95%CI: 0.55-0.83, p <0.001; BCSS: HR = 0.69, 95%CI: 0.56-0.86, p = 0.001) but not in the married (OS: HR = 0.89, 95%CI: 0.75-1.05, p = 0.177; BCSS: HR = 0.89, 95%CI: 0.75-1.05, p = 0.161), while no matter married or not, PMBR group had better OS and BCSS than mastectomy group but not BCT group. Conclusion Both of BCT and PMBR had improved survival compared to mastectomy for young women with operable breast cancer. The survival benefit of BCT compared to mastectomy remained significant in unmarried patients but not in married patients.
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