Journal of Cancer Research and Therapeutics

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 11  |  Issue : 5  |  Page : 29--31

Breast-conserving surgery versus modified radical mastectomy in treatment of early stage breast cancer: A retrospective study of 107 cases


Zhenhong Chen1, Ying Xu2, Jingde Shu1, Naixi Xu1,  
1 Department of Oncology Surgery, Quzhou Hospital of Zhejiang University, Zhejiang, Quzhou 324000, PR China
2 Department of Surgery, Quzhou Traditional Chinese Hospital, Zhejiang, Quzhou 324000, PR China

Correspondence Address:
Dr. Zhenhong Chen
Department of Oncology Surgery, Quzhou Hospital of Zhejiang University Zhejiang, Quzhou 324000
PR China

Abstract

Objective: The aim of this retrospective study was to evaluate the clinical efficacy and prognosis of breast-conserving surgery versus modified radical mastectomy in the treatment of early stage breast cancer. Patients and Methods: Two hundred and nineteen cases of early stage breast cancer were reviewed and retrospectively included in this study form two hospitals (Quzhou hospitalof Zhejiang university and Quzhou Traditional Chinese Hospital). The characteristics of operation procedure such as operation time, intraoperative blood loss and length of hospital stay were compared between the two groups. And the prognosis was recurrence rate was also compared to the two groups. Results: For the included 219 early breast cancer cases, 107 subjects received the breast-conserving operation, and other 112 cases received the modified radical mastectomy. The operation time, intraoperative blood loss and length of hospital stay were (56.7 ± 14.6) min, (39.2 ± 10.1) ml, (12.1 ± 2.1) day in the breast-conserving group and (95.6 ± 1 3.5) min, (79.5 ± 13.6) ml, (14.8 ± 3.2) day in the modified radical mastectomy group respectively. The operation time, intraoperative blood loss and length of hospital stay were smaller in the breast-conserving group as compared with modified radical mastectomy group with statistical difference (P < 0.05). The overall survival was compared with Kaplan-Meier curve by using log-rank test for the hazard ratio (HR). And the HR was 0.75 with its 95% confidence interval of 0.38-1.48, which indicated that no statistical difference of overall survival was existed between the two groups (P > 0.05). Conclusion: The breast-conserving operation was superior to modified radical mastectomy in the aspects of operation time, intraoperative blood loss and length of hospital stay.



How to cite this article:
Chen Z, Xu Y, Shu J, Xu N. Breast-conserving surgery versus modified radical mastectomy in treatment of early stage breast cancer: A retrospective study of 107 cases.J Can Res Ther 2015;11:29-31


How to cite this URL:
Chen Z, Xu Y, Shu J, Xu N. Breast-conserving surgery versus modified radical mastectomy in treatment of early stage breast cancer: A retrospective study of 107 cases. J Can Res Ther [serial online] 2015 [cited 2019 Nov 14 ];11:29-31
Available from: http://www.cancerjournal.net/text.asp?2015/11/5/29/163835


Full Text

 INTRODUCTION



Breast cancer is the leading cause of cancer-related death worldwide for women with increasing trend for recent years. It reported that approximately 230, 480 new cases of invasive breast cancer and 39,520 breast cancer deaths occurred among US women in 2011. [1] Surgery is important for the treatment of early stage breast cancer. And the operation procedure for breast experienced a long period of time. [2] Options for surgery procedure include breast-conserving surgery (BCS) and mastectomy. [3],[4] For BCS, the breast can be reconstructed at the same time as surgery or later on. BCS is also called partial (or segmental) mastectomy. It is also sometimes called lumpectomy or quadrantectomy. [5] In BCS, only the part of the breast containing the cancer is removed. [6] The goal is to remove cancer as well as some surrounding normal tissue. In this retrospective study, we reviewed and compared the prognosis of 219 early breast cancer patients who received BCS or modified radical mastectomy.

 Patients and Methods



Patients

Two hundred and nineteen cases of early stage breast cancer were reviewed and retrospectively included in this study from two hospitals (Quzhou Hospital of Zhejiang University and Quzhou Traditional Chinese Hospital) in the period from December 2006 to November 2012. The inclusion criteria was as flows: (1) Primary single breast tumor;(2) Tumor from areola o more than 3 cm; (3) The tumor located in the outer quadrant; (4) Tumor diameter <2 cm; (5) The tumor was confirmed by pathology. Of the included 219 early stage breast cancer patients, 107 subjects were treated with BCS and other 112 cases received a modified radical mastectomy. The general characteristics of the two groups are shown in [Table 1].{Table 1}

Methods

Two authors (Chen Zhenhong and Xu Ying) reviewed the patient's databases of Quzhou Medical College of Zhejiang University and Quzhou Central Hospital independently. We included the early stage breast cancer, according to the inclusion criteria. The intraoperative information (operation time and blood loss), length of hospital stay and survival were recorded and compared between the two groups.

Statistical analysis

The SPSS version 17.0 statistical software (Statistical Package for Social Sciences) (http://www-01.ibm.com/software/analytics/spss/) was used for the statistical analysis of the data. Demographic data of the patients were demonstrated as a number, percentage and mean value. Student's t-test was used for comparison of operation time, intraoperative blood loss and length of hospital stay. The overall survival was evaluated by Log-rank test. Two-tailed P < 0.05 was deemed as the statistically significant .

 RESULTS



Operation time, blood loss, and hospital stay

For the included 219 early breast cancer cases, 107 subjects received the breast-conserving operation, and other 112 cases received the modified radical mastectomy. The operation time, intraoperative blood loss and length of hospital stay were (56.7 ± 14.6) min, (39.2 ± 10.1) ml, (12.1 ± 2.1) day in the breast-conserving group and (95.6 ± 13.5) min, (79.5 ± 13.6) ml, (14.8 ± 3.2) day in the modified radical mastectomy group respectively. The operation time, intraoperative blood loss and length of hospital stay were smaller in the breast-conserving group compared with modified radical mastectomy group with statistical difference (P < 0.05) [Table 2].{Table 2}

Prognosis

The follow-up period range from 5 to 60 months for the two groups. In the breast-conserving group, 3 cases of recurrence and 13 cases of remote metastases were observed with the recurrence rate and metastases rate of 2.80% and 12.15%, respectively. In the modified radical mastectomy group, 1 cases of recurrence and 19 cases of remote metastases were observed with the recurrence rate and metastases rate of 0.89% and 16.96%, respectively. The 1-year, 3 years and 5 years survival rate were 95.33%, 87.85%, 85.98% and 95.54%, 86.61%, 83.04% for the breast-conserving and modified radical mastectomy group respectively [Table 3]. The overall survival was compared with Kaplan-Meier curve by using Log-rank test for the hazard ratio (HR). And the HR was 0.75 with its 95% confidence interval of 0.38-1.48, which indicated that no statistical difference of overall survival was existed between the two groups (P > 0.05) [Figure 1].{Figure 1}{Table 3}

 DISCUSSION



Breast cancer is one of the malignant tumors that seriously threaten the health of women. The incidence of the whole world is statistically increased from 1% to 8%/year. [7] Breast cancer has become the main cause of death for women in Europe and the United States. [8],[9] The morbidity of breast cancer in China is relative low compared to the United States. However in recent years, the incidence is on the raise. [10],[11]

With a rising diagnostic rate of breast cancer in early stage, and a progress of comprehensive treatment modality, BCS is considered to be an appropriate treatment for patients with stage I or II disease. [12] For most women with early stage breast cancer, BCS is as effective as mastectomy. Survival rates of women treated with BCS and mastectomy were not significant different. But BCS is not suitable for all women with breast cancer.

In this retrospective study, we compared the clinical efficacy and prognosis of two operation procedure - BCS and modified radical mastectomy-in the treatment of early stage breast cancer. In this study, we found that the operation time, intraoperative blood loss and length of hospital stay were smaller in breast-conserving group than that of modified radical mastectomy group. This result indicated the BCS was less invasive compared to the modified radical mastectomy. The length of hospital stay was also shorter in BCS compared to modified radical mastectomy. But, the overall survival for the two groups was not statistical different indicating the BCS not inferior to modified radical mastectomy in the aspect of prognosis.

 CONCLUSION



BCS was effective in the treatment of early stage breast cancer with less operation time and intraoperative blood and shorter length of hospital stay compared with modified radical mastectomy. But the results of this study are based on retrospective data which was easily affected by some bias. Hence, prospective randomized controlled trials need for further evaluation the two operation procedures.

Financial support and sponsorship

This study was supported by Quzhou science and technology project (No. 20051124).

Conflicts of interest

There are no conflicts of interest.

References

1Chen W, Zheng R, Zhang S, Zeng H, Fan Y, Qiao Y, et al. Esophageal cancer incidence and mortality in China, 2010. Thorac Cancer 2014;5:343-8.
2Halverson KJ, Taylor ME, Perez CA, Myerson R, Philpott G, Simpson JR, et al. Survival following breast-conserving surgery and irradiation or modified radical mastectomy in patients with invasive breast cancers with a maximum diameter of 1 cm. Mo Med 1993;90:759-63.
3Halsted CP, Benson JR, Jatoi I. A historical account of breast cancer surgery: Beware of local recurrence but be not radical. Future Oncol 2014;10:1649-57.
4Delpech Y, Barranger E. Breast cancer surgery. Rev Prat 2013;63:1395-9.
5van de Water W, Bastiaannet E, Scholten AN, Kiderlen M, de Craen AJ, Westendorp RG, et al. Breast-conserving surgery with or without radiotherapy in older breast patients with early stage breast cancer: A systematic review and meta-analysis. Ann Surg Oncol 2014;21:786-94.
6Boxer MM, Delaney GP, Chua BH. A review of the management of ductal carcinoma in situ following breast conserving surgery. Breast 2013;22:1019-25.
7Siegel R, Naishadham D, Jemal A. Cancer statistics for Hispanics/Latinos, 2012. CA Cancer J Clin 2012;62:283-98.
8Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5-29.
9Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin 2014;64:9-29.
10Fan L, Strasser-Weippl K, Li JJ, St Louis J, Finkelstein DM, Yu KD, et al. Breast cancer in China. Lancet Oncol 2014;15:e279-89.
11Hong W, Dong E. The past, present and future of breast cancer research in China. Cancer Lett 2014;351:1-5.
12Borgen PI, Heerdt AS, Moore MP, Petrek JA. Breast conservation therapy for invasive carcinoma of the breast. Curr Probl Surg 1995;32:191-248.