Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients

Marissa Corine van Maaren, L. de Munck, J.J. Jobsen, P. Poortmans, G.H. de Bock, Sabine Siesling, L.J.A. Strobbe

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Abstract

Purpose Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category. Methods All women diagnosed with primary invasive T1-2N2 breast cancer in 2000–2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry. Ten-year OS and DMFS were estimated using multivariable Cox regression. Excess mortality ratios (EMR) were calculated to estimate RS, using life tables of the general population. OS and RS were determined on the whole cohort, and DMFS on the 2003 cohort with completed follow-up. Missing data were imputed. Results Of 3071 patients, 1055 (34.4 %) received BCT and 2016 (65.7 %) MAST. BCT and MAST showed equal 10-year OS and RS. After stratification, BCT was significantly associated with improved 10-year OS [HRadjusted 0.82 (95 % CI 0.71–0.96)] and RS (EMRadjusted 0.81 (95 % CI 0.67–0.97]) in T2N2, but not in T1N2. Ten-year DMFS was equal for both treatments [HRadjusted 0.87 (95 % CI 0.64–1.18)] in the 2003 cohort (n = 594), which was representative for the full cohort. Conclusion BCT showed at least equal 10-year OS, RS, and DMFS compared to MAST. These results confirm that BCT is a good treatment option in T1-2N2 breast cancer
Original languageEnglish
Pages (from-to)511-521
JournalBreast cancer research and treatment
Volume160
Issue number3
DOIs
Publication statusPublished - 11 Oct 2016

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Mastectomy
Breast
Breast Neoplasms
Neoplasm Metastasis
Survival
Population
Radiotherapy
Therapeutics
Life Tables
Segmental Mastectomy
Netherlands
Registries
Dissection
Survival Rate
Mortality
Neoplasms

Keywords

  • METIS-318206
  • IR-101700

Cite this

@article{83ab1ef7a2dc4e2ca7234a2ef1db8a0c,
title = "Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients",
abstract = "Purpose Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category. Methods All women diagnosed with primary invasive T1-2N2 breast cancer in 2000–2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry. Ten-year OS and DMFS were estimated using multivariable Cox regression. Excess mortality ratios (EMR) were calculated to estimate RS, using life tables of the general population. OS and RS were determined on the whole cohort, and DMFS on the 2003 cohort with completed follow-up. Missing data were imputed. Results Of 3071 patients, 1055 (34.4 {\%}) received BCT and 2016 (65.7 {\%}) MAST. BCT and MAST showed equal 10-year OS and RS. After stratification, BCT was significantly associated with improved 10-year OS [HRadjusted 0.82 (95 {\%} CI 0.71–0.96)] and RS (EMRadjusted 0.81 (95 {\%} CI 0.67–0.97]) in T2N2, but not in T1N2. Ten-year DMFS was equal for both treatments [HRadjusted 0.87 (95 {\%} CI 0.64–1.18)] in the 2003 cohort (n = 594), which was representative for the full cohort. Conclusion BCT showed at least equal 10-year OS, RS, and DMFS compared to MAST. These results confirm that BCT is a good treatment option in T1-2N2 breast cancer",
keywords = "METIS-318206, IR-101700",
author = "{van Maaren}, {Marissa Corine} and {de Munck}, L. and J.J. Jobsen and P. Poortmans and {de Bock}, G.H. and Sabine Siesling and L.J.A. Strobbe",
year = "2016",
month = "10",
day = "11",
doi = "10.1007/s10549-016-4012-8",
language = "English",
volume = "160",
pages = "511--521",
journal = "Breast cancer research and treatment",
issn = "0167-6806",
publisher = "Springer",
number = "3",

}

Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients. / van Maaren, Marissa Corine; de Munck, L.; Jobsen, J.J.; Poortmans, P.; de Bock, G.H.; Siesling, Sabine; Strobbe, L.J.A.

In: Breast cancer research and treatment, Vol. 160, No. 3, 11.10.2016, p. 511-521.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Breast-conserving therapy versus mastectomy in T1-2N2 stage breast cancer: a population-based study on 10-year overall, relative, and distant metastasis-free survival in 3071 patients

AU - van Maaren, Marissa Corine

AU - de Munck, L.

AU - Jobsen, J.J.

AU - Poortmans, P.

AU - de Bock, G.H.

AU - Siesling, Sabine

AU - Strobbe, L.J.A.

PY - 2016/10/11

Y1 - 2016/10/11

N2 - Purpose Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category. Methods All women diagnosed with primary invasive T1-2N2 breast cancer in 2000–2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry. Ten-year OS and DMFS were estimated using multivariable Cox regression. Excess mortality ratios (EMR) were calculated to estimate RS, using life tables of the general population. OS and RS were determined on the whole cohort, and DMFS on the 2003 cohort with completed follow-up. Missing data were imputed. Results Of 3071 patients, 1055 (34.4 %) received BCT and 2016 (65.7 %) MAST. BCT and MAST showed equal 10-year OS and RS. After stratification, BCT was significantly associated with improved 10-year OS [HRadjusted 0.82 (95 % CI 0.71–0.96)] and RS (EMRadjusted 0.81 (95 % CI 0.67–0.97]) in T2N2, but not in T1N2. Ten-year DMFS was equal for both treatments [HRadjusted 0.87 (95 % CI 0.64–1.18)] in the 2003 cohort (n = 594), which was representative for the full cohort. Conclusion BCT showed at least equal 10-year OS, RS, and DMFS compared to MAST. These results confirm that BCT is a good treatment option in T1-2N2 breast cancer

AB - Purpose Our previous study demonstrated breast-conserving surgery with radiation therapy (BCT) to be at least equivalent to mastectomy in T1-2N0-1 breast cancer. Yet, 10-year survival rates after BCT and mastectomy with radiation therapy (MAST) in T1-2N2 breast cancer specifically have not been examined. Our study aimed to determine 10-year overall (OS), relative (RS), and distant metastasis-free survival (DMFS) in T1-2N2 breast cancer after BCT and MAST, stratified for T category. Methods All women diagnosed with primary invasive T1-2N2 breast cancer in 2000–2004, treated with BCT or MAST, both with axillary dissection and RT, were selected from the Netherlands Cancer Registry. Ten-year OS and DMFS were estimated using multivariable Cox regression. Excess mortality ratios (EMR) were calculated to estimate RS, using life tables of the general population. OS and RS were determined on the whole cohort, and DMFS on the 2003 cohort with completed follow-up. Missing data were imputed. Results Of 3071 patients, 1055 (34.4 %) received BCT and 2016 (65.7 %) MAST. BCT and MAST showed equal 10-year OS and RS. After stratification, BCT was significantly associated with improved 10-year OS [HRadjusted 0.82 (95 % CI 0.71–0.96)] and RS (EMRadjusted 0.81 (95 % CI 0.67–0.97]) in T2N2, but not in T1N2. Ten-year DMFS was equal for both treatments [HRadjusted 0.87 (95 % CI 0.64–1.18)] in the 2003 cohort (n = 594), which was representative for the full cohort. Conclusion BCT showed at least equal 10-year OS, RS, and DMFS compared to MAST. These results confirm that BCT is a good treatment option in T1-2N2 breast cancer

KW - METIS-318206

KW - IR-101700

U2 - 10.1007/s10549-016-4012-8

DO - 10.1007/s10549-016-4012-8

M3 - Article

VL - 160

SP - 511

EP - 521

JO - Breast cancer research and treatment

JF - Breast cancer research and treatment

SN - 0167-6806

IS - 3

ER -