Abstract | OBJECTIVES: MATERIALS AND METHODS: We conducted a retrospective cohort study of women with breast cancer diagnosed from 1994-2012. Data regarding patient and tumor characteristics and treatment specifics were captured electronically. Kaplan-Meier survival analyses were performed with inverse probability of treatment weighting to reduce selection bias effects in surgical assignment. RESULTS: Data from 5335 women were included, of which two-thirds had BCS and one-third had mastectomy. Surgical decision trends changed over time with more women undergoing mastectomy in recent years. Women who underwent BCS versus mastectomy differed significantly regarding age, cancer stage/grade, adjuvant radiation, chemotherapy, and endocrine treatment. Overall survival was similar for BCS and mastectomy. When BCS plus radiation was compared to mastectomy alone, 3-, 5-, and 10-year overall survival was 96.5% vs 93.4%, 92.9% vs 88.3% and 80.9% vs 67.2%, respectively. CONCLUSION: These analyses suggest that survival benefit is not related only to the surgery itself, but that the prognostic advantage of BCS plus radiation over mastectomy may also be related to the addition of adjuvant radiation therapy. This conclusion requires prospective confirmation in randomized trials.
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Authors | Adedayo A Onitilo, Jessica M Engel, Rachel V Stankowski, Suhail A R Doi |
Journal | Clinical medicine & research
(Clin Med Res)
Vol. 13
Issue 2
Pg. 65-73
(Jun 2015)
ISSN: 1554-6179 [Electronic] United States |
PMID | 25487237
(Publication Type: Comparative Study, Evaluation Study, Journal Article)
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Copyright | © 2015 Marshfield Clinic. |
Topics |
- Adult
- Aged
- Breast Neoplasms
(radiotherapy, surgery)
- Female
- Follow-Up Studies
- Humans
- Kaplan-Meier Estimate
- Mastectomy, Radical
- Mastectomy, Segmental
- Middle Aged
- Radiotherapy, Adjuvant
- Retrospective Studies
- Survival Rate
- Treatment Outcome
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