Comparative effectiveness study of breast-conserving surgery and mastectomy in the general population: A NCDB analysis

Kai Chen, Jieqiong Liu, Liling Zhu, Fengxi Su, Erwei Song, Lisa Jacobs

Research output: Contribution to journalArticle

Abstract

Purpose: Recent studies have revealed that breast-conserving surgery (BCS) with radiotherapy (RT) led to better survival than mastectomy in some populations. We compared the efficacy of BCS+RT and mastectomy using the National Cancer Database (NCDB, USA). Methods: Non-metastatic breast cancers in the NCDB from 2004-2011 were identified.The Kaplan-Meier method, Coxregression and propensity score analysis were used to compare the overall survival (OS) among patients with BCS+RT, mastectomy alone and mastectomy+RT. Results: A total of 160,880 patients with a median follow-up of 43.4 months were included. The respective 8-year OS values were 86.5%, 72.3% and 70.4% in the BCS+RT, mastectomy alone and mastectomy+RT group, respectively (P <0.001). After exclusion of patients with comorbidities, mastectomy (alone or with RT) remained associated with a lower OS in N0 and N1 patients. However, the OS of mastectomy+RT was equivalent to BCS+RT in N2-3 patients. Among patients aged 50 or younger, the OS benefit of BCS+RT over mastectomy alone was statistically significant (HR1.42, 95% CI 1.16-1.74), but not clinically significant (

Original languageEnglish (US)
Pages (from-to)40127-40140
Number of pages14
JournalOncotarget
Volume6
Issue number37
DOIs
StatePublished - 2015

Fingerprint

Segmental Mastectomy
Mastectomy
Radiotherapy
Population
Survival
Propensity Score
Comorbidity
Databases
Breast Neoplasms

Keywords

  • Breast cancer
  • Breast-conserving surgery
  • Mastectomy

ASJC Scopus subject areas

  • Oncology

Cite this

Comparative effectiveness study of breast-conserving surgery and mastectomy in the general population : A NCDB analysis. / Chen, Kai; Liu, Jieqiong; Zhu, Liling; Su, Fengxi; Song, Erwei; Jacobs, Lisa.

In: Oncotarget, Vol. 6, No. 37, 2015, p. 40127-40140.

Research output: Contribution to journalArticle

Chen, Kai ; Liu, Jieqiong ; Zhu, Liling ; Su, Fengxi ; Song, Erwei ; Jacobs, Lisa. / Comparative effectiveness study of breast-conserving surgery and mastectomy in the general population : A NCDB analysis. In: Oncotarget. 2015 ; Vol. 6, No. 37. pp. 40127-40140.
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