Comparative effectiveness of nipple-sparing mastectomy and breast-conserving surgery on long-term prognosis in breast cancer

被引:2
作者
Chen, Qitong [1 ,2 ]
Qu, Limeng [1 ,2 ]
He, Yeqing [1 ,2 ]
Deng, Yueqiong [1 ,2 ]
Zhou, Qin [1 ,2 ]
Yi, Wenjun [1 ,2 ]
机构
[1] Cent South Univ, Dept Gen Surg, Xiangya Hosp 2, Changsha, Hunan, Peoples R China
[2] Clin Res Ctr Breast Dis Hunan Prov, Changsha, Hunan, Peoples R China
来源
FRONTIERS IN ENDOCRINOLOGY | 2023年 / 14卷
基金
中国国家自然科学基金;
关键词
breast cancer; nipple-sparing mastectomy (NSM); propensity score matching (PSM); Surveillance Epidemiology and End Results (SEER); breast-conserving surgery (BCS); ONCOLOGICAL SAFETY; SKIN; RECONSTRUCTION; CONSERVATION; DISEASE;
D O I
10.3389/fendo.2023.1222651
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe frequency of nipple-sparing mastectomy (NSM) surgery is presently increasing. Nonetheless, there is a paucity of long-term prognosis data on NSM. This study compared the long-standing prognosis of NSM in relation to breast-conserving surgery (BCS).MethodsPopulation-level data for 438,588 female breast cancer patients treated with NSM or BCS and postoperative radiation from 2000 to 2018 were identified in the Surveillance, Epidemiology, and End Results (SEER) database; 321 patients from the Second Xiangya Hospital of Central South University were also included. Propensity score matching (PSM) was performed to reduce the influence of selection bias and confounding variables to make valid comparisons. The Kaplan-Meier analysis, log-rank test, and Cox regression were applied to analyze the data.ResultsThere were no significant differences in long-term survival rates between patients who underwent NSM and those who underwent BCS+radiotherapy (BCS+RT), as indicated by the lack of significant differences in overall survival (OS) (p = 0.566) and breast cancer-specific survival (BCSS) (p = 0.431). Cox regression indicated that NSM and BCS+RT had comparable prognostic values (p = 0.286) after adjusting for other clinicopathological characteristics. For OS and BCSS, subgroup analysis showed that the majority of patients achieved an analogous prognosis whether they underwent NSM or BCS. The groups had comparable recurrence-free survival (RFS), with no significant difference found (p = 0.873).ConclusionsThis study offers valuable insights into the long-term safety and comparative effectiveness of NSM and BCS in the treatment of breast cancer. These findings can assist clinicians in making informed decisions on a case-by-case basis.
引用
收藏
页数:15
相关论文
共 25 条
[1]  
Adamo M., 2020, Bethesda MD: Natl Cancer Institute
[2]   Therapeutic nipple-sparing mastectomy: trends based on a national cancer database [J].
Agarwal, Shailesh ;
Agarwal, Sunil ;
Neumayer, Leigh ;
Agarwal, Jayant P. .
AMERICAN JOURNAL OF SURGERY, 2014, 208 (01) :93-98
[3]  
[Anonymous], 1975, SURVEILLANCE EPIDEMI
[4]   Modern Approaches to the Surgical Management of Malignant Breast Disease The Role of Breast Conservation, Complete Mastectomy, Skin- and Nipple-Sparing Mastectomy [J].
Cil, Tulin D. ;
McCready, David .
CLINICS IN PLASTIC SURGERY, 2018, 45 (01) :1-+
[5]   Increasing Eligibility for Nipple-Sparing Mastectomy [J].
Coopey, Suzanne B. ;
Tang, Rong ;
Lei, Lan ;
Freer, Phoebe E. ;
Kansal, Kari ;
Colwell, Amy S. ;
Gadd, Michele A. ;
Specht, Michelle C. ;
Austen, William G., Jr. ;
Smith, Barbara L. .
ANNALS OF SURGICAL ONCOLOGY, 2013, 20 (10) :3218-3222
[6]   Overall Survival, Disease-Free Survival, Local Recurrence, and Nipple-Areolar Recurrence in the Setting of Nipple-Sparing Mastectomy: A Meta-Analysis and Systematic Review [J].
De La Cruz, Lucy ;
Moody, Alison M. ;
Tappy, Erryn E. ;
Blankenship, Stephanie A. ;
Hecht, Eric M. .
ANNALS OF SURGICAL ONCOLOGY, 2015, 22 (10) :3241-3249
[7]  
Freeman B S, 1976, Clin Plast Surg, V3, P277
[8]   Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications [J].
Galimberti, Viviana ;
Vicini, Elisa ;
Corso, Giovanni ;
Morigi, Consuelo ;
Fontana, Sabrina ;
Sacchini, Virgilio ;
Veronesi, Paolo .
BREAST, 2017, 34 :S82-S84
[9]   The Oncological Safety of Skin Sparing Mastectomy with Conservation of the Nipple-Areola Complex and Autologous Reconstruction: An Extended Follow-Up Study [J].
Gerber, Bernd ;
Krause, Annette ;
Dieterich, Max ;
Kundt, Guenther ;
Reimer, Toralf .
ANNALS OF SURGERY, 2009, 249 (03) :461-468
[10]   Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer [J].
Hartmann, LC ;
Schaid, DJ ;
Woods, JE ;
Crotty, TP ;
Myers, JL ;
Arnold, PG ;
Petty, PM ;
Sellers, TA ;
Johnson, JL ;
McDonnell, SK ;
Frost, MH ;
Jenkins, RB .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 340 (02) :77-84