T3 breast cancer: BCT, mastectomy on par for survival

  • Mazor AM & al.
  • Breast Cancer Res Treat
  • 20.10.2018

  • von Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Breast conservation therapy (BCT) and mastectomy share similar OS in a large cohort of patients with T3 breast cancer (>5 cm).

Why this matters

  • Tumor size >5 cm should not be exclusionary for BCT.

Study design

  • Retrospective cohort (n=37,268) of patients with noninflammatory breast cancer >5 cm (2004-2011) in the National Cancer Database (NCDB) who underwent BCT (15%) or mastectomy (85%).
  • Skin or chest wall involvement were excluded.
  • Funding: US Public Health Service; Fox Chase Cancer Center Board of Associates.

Key results

  • The BCT group had smaller tumor size (6.0 cm vs 6.7 cm in the mastectomy group; P<.001>
  • Median follow-up was 51.4 months.
  • The BCT group had similar OS as the mastectomy group (P=.357), with a 5-year adjusted OS of 68% vs 69%, respectively (P=.63).
  • The largest predictors of BCT were administration of neoadjuvant chemotherapy (P<.001 grade iii tumors and black race>
  • BCT receipt decreased from 17.5% in 2004 to 15% in 2011 (P<.001 despite no change in tumor size>trend=.22).

Limitations

  • Observational design.