Survival is Better After Breast Conserving Therapy than Mastectomy for Early Stage Breast Cancer: A Registry-Based Follow-up Study of Norwegian Women Primary Operated Between 1998 and 2008.
Survival is Better After Breast Conserving Therapy than Mastectomy for Early Stage Breast Cancer: A Registry-Based Follow-up Study of Norwegian Women Primary Operated Between 1998 and 2008.
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DOI：
10.1245/s10434-015-4441-3
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发表时间：
2015-11
影响因子：
3.7
通讯作者：
Nygård JF
中科院分区：
文献类型：
--
作者：
Hartmann-Johnsen OJ;Kåresen R;Schlichting E;Nygård JF
保乳治疗（BCT）和乳房切除术（MTX）被认为具有相似的长期生存期。然而，美国最近的两项登记研究发现，与MTX相比，接受BCT的女性生存率更高。本研究的目的是比较挪威早期乳腺癌妇女接受BCT和MTX治疗后的生存率。1998-2008年浸润性早期乳腺癌患者中，BCT和MTX被认为是同样有益的治疗方法，共纳入13015名妇女。手术分为两个主要队列（原发性BCT，原发性MTX）和五个亚队列。分析分为T1N0M0、T2N0M0、T1N1M0、T2N1M0和年龄组（<50、50 - 69、≥70）。总生存期和乳腺癌特异性生存期（BCSS）通过生命表、Cox回归风险比和敏感性分析计算。接受原发性BCT或原发性MTX治疗的妇女的5年BCSS分别为97%和88%。在调整诊断年份、诊断年龄、分期、组织学和分级后，与接受原发性BCT的女性相比，接受原发性MTX治疗的女性乳腺癌死亡风险比为1.64（95%可信区间1.43-1.88）。在所有早期阶段、手术亚群和年龄组中，保乳治疗后的生存率优于或等于乳房切除术。这种优势不仅可以归因于肿瘤生物学的差异。
Breast-conserving therapy (BCT) and mastectomy (MTX) has been considered to have a similar long-time survival. However, better survival in women undergoing BCT compared with MTX is found in two recent register studies from the United States. The purpose of this study was to compare survival after BCT and MTX for women with early-stage breast cancer in Norway. Women with invasive, early-stage breast cancer (1998–2008) where BCT and MTX were considered as equally beneficial treatments were included for a total of 13,015 women. Surgery was divided in two main cohorts (primary BCT, primary MTX) and five subcohorts. Analyses were stratified into T1N0M0, T2N0M0, T1N1M0, T2N1M0, and age groups (<50, 50–69, ≥70). Overall survival and breast cancer-specific survival (BCSS) were calculated in life tables, hazard ratios by Cox regression, and sensitivity analyses. Five-year BCSS for women who underwent primary BCT or primary MTX was 97 and 88 %, respectively. Women who underwent primary MTX had a hazard ratio of 1.64 (95 % confidence interval 1.43–1.88) for breast cancer death compared with women who underwent primary BCT after adjusting for the year of diagnosis, age at diagnosis, stage, histology, and grade. Survival was better or equal after breast-conserving therapy than mastectomy in all early stages, surgical subcohorts, and age groups. This advantage could not only be attributed to differences in tumor biology.