A standard mastectomy should not be the only recommended breast surgical treatment for non-metastatic inflammatory breast cancer: A large population-based study in the Surveillance, Epidemiology, and End Results database 18

摘要

Abstract Background Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. Methods The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013. Comparisons of the proportions of various breast surgery procedures over the years were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier product limit method and compared across groups using the log-rank statistic. Cox models were then fitted to compare the association between various breast surgical procedures and BCSS or OS after adjusting for patient and tumor characteristics. Results A total of 3374 cases were identified. Over the years, the proportion of contralateral prophylactic mastectomy (CPM), breast reconstruction and both were increasing. The proportion of implant-based reconstruction was also increasing with no difference in survival compared with other types of reconstruction. There was no statistically significant difference in BCSS or OS among various breast surgery treatments, such as breast conserving surgery, CPM, breast reconstruction and standard unilateral mastectomy. Conclusions Breast surgery is of great significance to the clinical outcome of IBC. Standard mastectomy should not be the only recommended breast surgical treatment. Highlights ? Breast surgery is of great significance to the clinical outcome of inflammatory breast cancer (IBC). ? Over the years, an increased rate of contralateral prophylactic mastectomy (CPM), breast reconstruction and both was observed. ? The rate of implant-based reconstruction was increasing with no difference in survival compared with other types of reconstruction procedure. ? There was no statistically significant difference in BCSS or OS among various breast surgerical treatments. ? Individualized surgical procedures can be safely performed in non-metastatic IBC patients based on the response of NAC and patients' preference. ]]>