Abstract
BackgroundThe influence of surgical approaches [including mastectomy, breast-conserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR) on prognosis of young women (<40 years old) with operable breast cancer has not been determined yet, and this might vary in patients with different marital statuses. Therefore, we aimed to investigate the effect of surgery on survival outcomes for young women with operable breast cancer in different marital statuses.MethodsWe used the Surveillance, Epidemiology, and End Results (SEER) database to identify young women with operable breast cancer between 2004 and 2016, who underwent mastectomy, BCT or PMBR. We assessed overall survival (OS) and breast cancer-specific survival (BCSS) using the Kaplan–Meier method and hazard ratios using multivariate Cox proportional hazard regression.ResultsCompared to mastectomy, both of BCT and PMBR conferred better OS (BCT: HR = 0.79, 95%CI: 0.69–0.90, p <0.001; PMBR: HR = 0.70, 95%CI: 0.63–0.78, p <0.001) and BCSS (BCT: HR = 0.79, 95%CI: 0.69–0.91, p = 0.001; PMBR: HR = 0.73, 95%CI: 0.65–0.81, p <0.001), but there was no significant difference of survival between BCT and PMBR group. The survival benefit of BCT compared to mastectomy remained significant in unmarried young women (OS: HR = 0.68, 95%CI: 0.55–0.83, p <0.001; BCSS: HR = 0.69, 95%CI: 0.56–0.86, p = 0.001) but not in the married (OS: HR = 0.89, 95%CI: 0.75–1.05, p = 0.177; BCSS: HR = 0.89, 95%CI: 0.75–1.05, p = 0.161), while no matter married or not, PMBR group had better OS and BCSS than mastectomy group but not BCT group.ConclusionBoth of BCT and PMBR had improved survival compared to mastectomy for young women with operable breast cancer. The survival benefit of BCT compared to mastectomy remained significant in unmarried patients but not in married patients.
Highlights
Nowadays, treatment strategies for breast cancer have been improved largely, including surgery, radiation, chemotherapy, endocrine therapy, target therapy and immune therapy [1]
The present study aimed to investigate the impact of surgical approaches on the overall survival (OS) and breast cancer-specific survival (BCSS) for young patients with operable breast cancer in different marital statuses using the Surveillance, Epidemiology, and End Results (SEER) database
By investigating the survival outcomes of young women with operable breast cancer treated with mastectomy, breast-conserving therapy (BCT) or post-mastectomy breast reconstruction (PMBR) in a population of 20,885 patients from the SEER database, our study found that BCT or PMBR had improved OS and breast cancerspecific survival (BCSS) compared with mastectomy for young women with operable breast cancer, which remained significant in subgroup of unmarried patients
Summary
Treatment strategies for breast cancer have been improved largely, including surgery, radiation, chemotherapy, endocrine therapy, target therapy and immune therapy [1]. Surgical treatment, such as mastectomy alone, breast-conserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR), is still considered to be the most significant treatment. For breast cancer in young women, which are defined as women under the age of 40 at breast cancer diagnosis, the survival benefit of BCT compared with mastectomy was uncertain, though some studies had been reported that BCT brought better body image and less anxiety for young breast cancer survivors [7, 8]. The influence of surgical approaches [including mastectomy, breastconserving therapy (BCT) and post-mastectomy breast reconstruction (PMBR) on prognosis of young women (
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