Breast-Conserving Surgery in Patients With Mammary Paget's Disease.

Abstract

BACKGROUND:

We aimed to analyze the association between Paget's disease (PD) and breast cancer (BC) subtypes and compare the effect of breast-conserving surgery (BCS) as a local treatment with mastectomy for PD.

MATERIALS AND METHODS:

Data of patients with histologic type International Classification of Diseases-0-3 8540-8543 who were treated from 1973 to 2014 were retrieved from the Surveillance, Epidemiology, and End Results database of the National Cancer Institute. A chi-square test was used to identify differences in categorical data among different groups. Overall survival (OS) was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, sequential landmark analysis, and propensity score-matched analysis.

RESULTS:

The study cohort included 5398 patients. Triple-negative BC accounted for the fewest patients with PD-only (1/22, 4.54%), Paget's disease-ductal carcinoma in situ (PD-DCIS) (3/48, 6.25%), and Paget's disease-invading ductal carcinoma (PD-IDC) (23/352, 6.53%). According to the results of the log-rank test and Cox analysis, the 10-year OS rates were similar for the BCS and mastectomy subgroups among patients with PD-DCIS or PD-IDC. Furthermore, there were no significant differences in survival benefits among the different surgeries after propensity score matching. Landmark analyses for OS of patients with PD-DCIS or PD-IDC surviving more than 1, 3, and 5 y showed no significant differences in survival. There were statistical differences in 10-year OS rates for patients with PD-DCIS or PD-IDC who underwent radiation therapy, or not, following BCS (both, P < 0.001).

CONCLUSIONS:

For patients with PD-DCIS or PD-IDC, breast conservation therapy with lumpectomy and radiation is an effective local treatment strategy, compared with mastectomy.

• Authors: Yufeng Yao, Li Sun, Yan Meng, Yan Zhuang, Lin Zhao, Qiao Yu, Chengshuai Si
• Journal: The Journal of surgical research (J Surg Res) Vol. 241 Pg. 178-187 (09 2019) ISSN: 1095-8673 [Electronic] United States
• PMID: 31026796 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Topics

• Breast (pathology, surgery)
• Breast Neoplasms (mortality, pathology, therapy)
• Breast Neoplasms, Male (mortality, pathology, therapy)
• Carcinoma, Ductal, Breast (mortality, pathology, therapy)
• Carcinoma, Intraductal, Noninfiltrating (mortality, pathology, therapy)
• Female
• Humans
• Kaplan-Meier Estimate
• Lymph Node Excision (statistics & numerical data)
• Male
• Mastectomy, Radical (methods, statistics & numerical data, trends)
• Mastectomy, Segmental (methods, statistics & numerical data, trends)
• Paget's Disease, Mammary (mortality, pathology, therapy)
• Patient Selection
• Radiotherapy, Adjuvant (statistics & numerical data)
• Retrospective Studies
• SEER Program (statistics & numerical data)
• Treatment Outcome