title: The different outcomes between breast-conserving surgery and mastectomy in triple-negative breast cancer: a population-based study from the SEER 18 database.
abstract: Breast-conserving surgery (BCS) including radiotherapy (RT) has been demonstrated to provide at least equivalent prognosis to mastectomy in early-stage breast cancer. However, studies on triple-negative breast cancer (TNBC) patients are relatively scarce. The current population-based study aimed to investigate the distinct outcomes between BCS+RT and mastectomy in patients with TNBC. Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, we enrolled 11,514 female TNBC cases diagnosed during the years 2010-2013. Those patients were subdivided into BCS+RT (5,469) and mastectomy groups (6,045), and we conducted a survival comparison between the two groups. The endpoints were breast cancer-specific survival (BCSS) and overall survival (OS). In the overall cohort, patients with BCS+RT exhibited distinctly better breast cancer-specific survival (BCSS) (log-rank, p < 0.001) and overall survival (OS) (log-rank, p < 0.001) than did mastectomy patients. When stratifying the TNBC patients according to age, histology grade, TNM stage, tumor size, and lymph node (LN) status, most patients in the BCS+RT group presented with better survival than did the patients in the mastectomy group, except for the grade I (log-rank, p = 0.830, both BCSS and OS) and stage I (log-rank, BCSS, p = 0.127; OS, p = 0.093) patients. In addition, after adjusting for confounding variables by multivariable Cox proportional hazard analysis, BCS+RT still tended to present with higher BCSS and OS. In conclusion, from our study on SEER data, BCS+RT displayed elevated BCSS and OS in TNBC patients compared to mastectomy, at least equally. Our study provided further evidence for surgeons that BCS with RT is available for TNBC patients.
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Qing-Xia
authors.initials: QX
authors.lastname: Chen
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Wang
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Pei-Yang
authors.initials: PY
authors.lastname: Lin
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Jun-Jing
authors.initials: JJ
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.
authors.forename: Chuan-Gui
authors.initials: CG
authors.lastname: Song
authors.affiliation: Department of Breast Surgery, Key Laboratory of Breast Cancer, Fudan University Shanghai Cancer Center, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Shao
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D016019:Survival Analysis; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D055815:Young Adult
keywords: breast cancer-specific survival; breast-conserving surgery; mastectomy; overall survival; triple-negative breast cancer