Breast-conserving therapy achieves locoregional outcomes comparable to mastectomy in women with T1-2N0 triple-negative breast cancer Journal Article


Authors: Zumsteg, Z. S.; Morrow, M.; Arnold, B.; Zheng, J.; Zhang, Z.; Robson, M.; Traina, T.; McCormick, B.; Powell, S.; Ho, A. Y.
Article Title: Breast-conserving therapy achieves locoregional outcomes comparable to mastectomy in women with T1-2N0 triple-negative breast cancer
Abstract: Background: Conflicting data exist regarding optimum local therapy for early-stage triple-negative breast cancer (TNBC). We examined outcomes according to local treatment type in a large cohort of node-negative TNBC patients. Methods: A total of 1,242 consecutive patients with TNBC treated at a single institution from 1999 to 2008 were identified. Of these, 646 with pathologic stage T1-2N0 TNBC underwent breast-conserving therapy (BCT) (N = 448) or total mastectomy (TM) without postmastectomy radiation (N = 198) and comprised the study population. Locoregional recurrence (LRR), distant metastasis (DM), and overall recurrence were investigated with a competing risk analysis using Gray's test and multivariable Fine and Gray competing risk regression. Overall survival was assessed using standard Kaplan-Meier methods and a Cox proportional hazards analysis. Results: Median follow-up was 78.3 months (range 1-156). Eight-one percent of patients received adjuvant chemotherapy. TM patients were younger, were more likely to have lymphovascular invasion, and had larger tumors than patients undergoing BCT (all P ≤ 0.05). The 5-year cumulative incidence of LRR was 4.2 and 5.4 % for patients undergoing BCT and TM, respectively. There was no significant difference in LRR, DM, overall recurrence, disease free survival, or overall survival between groups on univariate analysis, or after adjusting for other variables in multivariate models. Lack of chemotherapy and high tumor stage independently predicted for decreased overall survival (both P < 0.001). Conclusions: A low, 5-year risk of LRR (4.7 %) was achieved in a large group of women with T1-2N0 TNBC treated with multimodality therapy. BCT was as equally effective as TM for local and distant control. © 2013 Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 20
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2013-10-01
Start Page: 3469
End Page: 3476
Language: English
DOI: 10.1245/s10434-013-3011-9
PROVIDER: scopus
PUBMED: 23686101
PMCID: PMC5730455
DOI/URL:
Notes: --- - Cited By (since 1996):1 - "Export Date: 1 October 2013" - "CODEN: ASONF" - "Source: Scopus"
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MSK Authors
  1. Alice Yoosun Ho
    119 Ho
  2. Zhigang Zhang
    318 Zhang
  3. Junting Zheng
    172 Zheng
  4. Monica Morrow
    601 Morrow
  5. Simon Nicholas Powell
    228 Powell
  6. Mark E Robson
    541 Robson
  7. Tiffany A Traina
    204 Traina
  8. Beryl McCormick
    333 McCormick
  9. Zachary Stephan Zumsteg
    35 Zumsteg
  10. Brittany Berasi Arnold
    9 Arnold