title: Locoregional and distant recurrences after breast conserving therapy in patients with triple-negative breast cancer: a meta-analysis.
abstract: BACKGROUND
  With higher incidence of recurrence, ongoing dispute exists on whether triple-negative breast cancer (TNBC) is a good candidate for breast conserving therapy (BCT).
  
  
  OBJECTIVE
  We aimed to appraise the safety of BCT in treating TNBC, in comparison with modified radical mastectomy. The prognostic effect of TN phenotype in conservatively managed patients was also assessed.
  
  
  METHODS
  A systematic search for studies regarding recurrences in patients with TNBC or treated by BCT was conducted up to March 2013. Summary relative risks (RRs) for ipsilateral locoregional recurrence (ILRR) and distant metastasis (DM) were calculated in a fixed-effects model.
  
  
  RESULTS
  Twenty-two studies concerning 15,312 breast cancer patients were analyzed. In the cohort of TNBC, the patients receiving BCT were less likely to develop ILRR and DM in comparison with mastectomy (RR 0.75, 95% CI 0.65-0.87; RR 0.68, 95% CI 0.60-0.76). In the cohort of BCT, the TN subtype increased the risks of both ILRR and DM than non-TN subtypes (RR 1.88, 95% CI 1.58-2.22; RR 2.12, 95% CI 1.72-2.62). Further subgroup analyses of BCT cohort revealed that the luminal phenotype had the most favorable prognosis. Notably, TN subtype was less likely to develop ILRR than HER-2 subtype (RR 0.69, 95% CI 0.53-0.91), there was no difference in DM rate between them.
  
  
  CONCLUSIONS
  BCT benefits patients with TNBC than mastectomy does. However, TN subtype predicts a poorer prognosis than non-TN subtype, suggesting more aggressive adjuvant therapy for TNBC be established in future trials.
authors.affiliation: Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Xie
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Tang
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Pan
authors.forename: Yefan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Mengyang
authors.initials: M
authors.lastname: Di
mesh_terms: D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D011183:Postoperative Complications; D011379:Prognosis; D064726:Triple Negative Breast Neoplasms / Q000601:surgery*
keywords: Breast conserving therapy; Distant metastasis; Locoregional recurrence; Mastectomy; Triple-negative breast cancer