Is Breast-Conserving Therapy Appropriate for Male Breast Cancer Patients? A National Cancer Database Analysis
Is Breast-Conserving Therapy Appropriate for Male Breast Cancer Patients? A National Cancer Database Analysis
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DOI：
10.1245/s10434-019-07159-4
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发表时间：
2019-07-01
影响因子：
3.7
通讯作者：
Sauder, Candice A. M.
中科院分区：
文献类型：
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作者：
Bateni, Sarah B.;Davidson, Anders J.;Sauder, Candice A. M.
背景目前男性乳腺癌的治疗指南主要是由女性临床试验指导的。由于缺乏研究，目前还不清楚保乳治疗（BCT）是否等同于男性乳房切除术。我们试图比较接受BCT和乳房切除术的男性乳腺癌患者的总生存率（OS）。我们对来自国家癌症数据库（2004 - 2014）的8445例I-II期（T1 - 2 N0 - 1 M0）男性乳腺癌患者进行了回顾性分析。根据手术和放射治疗（RT）对患者进行分组。BCT定义为部分乳房切除术后行RT。多变量和治疗加权逆概率（IPTW）考克斯比例风险模型用于比较治疗组之间的OS，控制人口统计学和临床病理学特征。大多数患者接受了全乳房切除术（61.2%），而18.2%接受了BCT，12.4%接受了全乳房切除术和RT，8.2%仅接受了部分乳房切除术。在多变量和IPTW模型中，与BCT相比，单纯部分乳房切除术、单纯全乳房切除术和全乳房切除术联合RT与更差的OS相关（p
Background. Current treatment guidelines for male breast cancer are predominantly guided by female-only clinical trials. With scarce research, it is unclear whether breast-conserving therapy (BCT) is equivalent to mastectomy in men. We sought to compare overall survival (OS) among male breast cancer patients who underwent BCT versus mastectomy.Methods. We performed a retrospective analysis of 8445 stage I-II (T1-2 N0-1 M0) male breast cancer patients from the National Cancer Database (2004-2014). Patients were grouped according to surgical and radiation therapy (RT). BCT was defined as partial mastectomy followed by RT. Multivariable and inverse probability of treatment-weighted (IPTW) Cox proportional hazards models were used to compare OS between treatment groups, controlling for demographic and clinicopathologic characteristics.Results. Most patients underwent total mastectomy (61.2%), whereas 18.2% underwent BCT, 12.4% underwent total mastectomy with RT, and 8.2% underwent partial mastectomy alone. In multivariable and IPTW models, partial mastectomy alone, total mastectomy alone, and total mastectomy with RT were associated with worse OS compared with BCT (p