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Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Breast-conserving surgery (BCS) has been reported to have better survival rates when compared with total mastectomy (TM) in early breast cancer. We evaluated the long-term outcomes of Korean women with early breast cancer who underwent either BCS plus radiotherapy (RT) or TM.

Methods

In this population-based study, we evaluated 45,770 patients from the Korean Breast Cancer Registry (KBCR) who were diagnosed with early breast cancer, and divided them into the BCS + RT and TM groups. To minimize bias caused by factors other than the surgical method, we used exact match pairing of prognostic factors. We compared the 10-year overall survival (OS) and breast cancer-specific survival (BCSS) before and after exact matching. As the KBCR is a multicenter, online-based registry program, we used the Asan Medical Center (AMC) database, a single-center database, to validate the results from the KBCR database.

Results

In both the KBCR and AMC cohorts, the BCS + RT group showed better OS and BCSS than the TM group, before and after exact matching. For the KBCR cohort after exact matching, the hazard ratios for OS and BCSS were 1.541 (95% confidence interval [CI] 1.392–1.707, p < 0.001) and 1.405 (95% CI 1.183–1.668, p < 0.001), respectively, favoring the BCS + RT group. For the AMC cohort after exact matching, the hazard ratios for OS and BCSS were 1.854 (95% CI 1.476–2.328, p < 0.001) and 1.807 (95% CI 1.186–2.752, p = 0.006), respectively.

Conclusions

Our results suggest that BCS + RT is at least equivalent to TM in terms of OS and may affect treatment decisions in early breast cancer patients.

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Acknowledgement

This study was supported by a Grant (Elimination of Cancer Project Fund) from the Asan Cancer Institute of the AMC, Seoul (2017-1341), and this article was supported by the Korean Breast Cancer Society.

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Hakyoung Kim M.D., Sae Byul Lee M.D., Ph.D., Jisun Kim M.D., Ph.D.,  Yong Chung M.D., Hee Jeong Kim M.D., Beom Seok Ko M.D., Ph.D., Jong Won Lee M.D., Ph.D., Byung Ho Son M.D., Ph.D. & Sei Hyun Ahn M.D., Ph.D.

  2. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seok-Jin Nam M.D., Ph.D.

  3. Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea

    Eun Sook Lee M.D., Ph.D.

  4. Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Byeong-Woo Park M.D., Ph.D.

  5. Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Korea

    Ho Yong Park M.D., Ph.D.

  6. Segyero Hospital, Busan, Korea

    Hyouk Jin Lee M.D.

Authors
  1. Hakyoung Kim M.D.
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  2. Sae Byul Lee M.D., Ph.D.
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  3. Seok-Jin Nam M.D., Ph.D.
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  4. Eun Sook Lee M.D., Ph.D.
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  5. Byeong-Woo Park M.D., Ph.D.
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  6. Ho Yong Park M.D., Ph.D.
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  7. Hyouk Jin Lee M.D.
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  8. Jisun Kim M.D., Ph.D.
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  9. Yong Chung M.D.
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  10. Hee Jeong Kim M.D.
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  11. Beom Seok Ko M.D., Ph.D.
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  12. Jong Won Lee M.D., Ph.D.
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  13. Byung Ho Son M.D., Ph.D.
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  14. Sei Hyun Ahn M.D., Ph.D.
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Corresponding author

Correspondence to Sae Byul Lee M.D., Ph.D..

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Disclosure

Hakyoung Kim, Sae Byul Lee, Seok-Jin Nam, Eun Sook Lee, Byeong-Woo Park, Ho Yong Park, Hyouk Jin Lee, Jisun Kim, Il Yong Chung, Hee Jeong Kim, Beom Seok Ko, Jong Won Lee, Byung Ho Son, Sei Hyun Ahn declare they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Kim, H., Lee, S.B., Nam, SJ. et al. Survival of Breast-Conserving Surgery Plus Radiotherapy versus Total Mastectomy in Early Breast Cancer. Ann Surg Oncol 28, 5039–5047 (2021). https://doi.org/10.1245/s10434-021-09591-x

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  • DOI: https://doi.org/10.1245/s10434-021-09591-x

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