Breast cancer: repeat lumpectomy for IBTR tied to lower survival

  • Su Y & al.
  • Oncologist
  • 6 Mar 2019

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Mastectomy is the standard treatment for ipsilateral breast tumor recurrence (IBTR), but little is known about repeat lumpectomy in lieu of mastectomy.
  • This study found that repeat lumpectomy alone for IBTR is associated with higher mortality than mastectomy.
  • If the tumor is ≤1 cm, repeat lumpectomy plus radiotherapy (RT) is associated with no difference in mortality vs mastectomy.

Why this matters

  • In women with breast cancer, repeat lumpectomy should not be considered for IBTR unless it is accompanied by RT and if the tumor size is ≤1 cm.

Study design

  • Population-based retrospective cohort of 5098 patients with IBTR (1973-2013), 79.4% of whom underwent mastectomy and 20.6% who underwent repeat lumpectomy in the Surveillance, Epidemiology and End Results (SEER) database.
  • Funding: Shenkang Center City Hospital.

Key results

  • Repeat lumpectomy (vs mastectomy) for IBTR is associated with higher overall mortality (HR, 1.522; P<.001 and higher cancer-specific mortality p>
  • Repeat lumpectomy plus RT (vs mastectomy) for IBTR is associated with no difference in overall mortality, but higher cancer-specific mortality (HR, 1.540; P=.032).
    • In the subgroup with pathological tumor size of ≤1 cm, repeat lumpectomy plus RT (vs mastectomy) for IBTR is associated with no difference in overall mortality or cancer-specific mortality.

Limitations

  • Observational design.
  • Those who received lumpectomy were older than those who received mastectomy.