Survival after Breast-Conserving Operation Compared with Mastectomy

Abstract

Chu and colleagues ¹ Chu Q.D. Hsieh M.C. Lyons J.M. Wu X.C. 10-Year survival after breast-conserving surgery compared with mastectomy in Louisiana women with early-stage breast cancer: a population-based study. J Am Coll Surg. 2020 Dec 7 [Online ahead of print]; Abstract Full Text Full Text PDF Scopus (1) Google Scholar report results of a large observational study of women with early stage breast cancer (ESBC), and show that mastectomy (MST) is associated with an increased risk of death from all causes (hazard ratio [HR]: 1.286; 95%CI: 1.197–1.380) and an increased risk of breast cancer-specific death (HR: 1.298; 95%CI: 1.150–1.465), when compared with breast-conserving operation plus radiation (BCT). The authors conclude, “Our results provide compelling evidence to encourage patients to consider a BCT rather than MST for ESBC, when appropriate.” However, the evidence from their observational study should not supplant the evidence from 6 large randomized trials that have consistently shown equivalent survival outcomes between patients treated with BCT and MST. ² Jatoi I. Proschan M.A. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results. Am J Clin Oncol. 2005; 28 : 289-294 Crossref PubMed Scopus (170) Google Scholar