Efficacy comparison of breast conserving surgery versus radical mastectomy in triple negative breast cancer patients: a meta-analysis

Abstract

Objective To evaluate the effect of breast conserving surgery (BCS) versus radical mastectomy on the prognosis of triple negative breast cancer (TNBC) patients. Methods The databases (PubMed, Embase, MEDLINE, CNKI, VIP, WanFang) were searched for the related studies that met the requirements. Two reviewers independently screened the literature and extracted the data, such as number of cases, survival curve, hazard ratio (HR). The methodological quality of included studies was accessed using the Newcastle-Ottawa Scale (NOS). If HR was not mentioned in the papers, Engauge Digitizer 6.2 software was used to extract the survival curve data of each study, and then the ln(HR) and se[ln(HR)] of mastectomy versus BCS in the OS, DFS and local-regional recurrence-free survival (LRRFS) were calculated. If HR was mentioned in the papers, the ln(HR) and se[ln(HR)] were calculated directly. Finally, a meta-analysis was performed using RevMan 5.3 software. Results Totally 10 eligible studies were included, with 5 487 triple negative breast cancer patients involved. The NOS scores of all included studies were 7-9, indicating high methodological quality. In 10 cohort studies of TNBC, the OS of patients receiving BCS was significantly higher than that of patients receiving radical mastectomy (HR=1.25, 95%CI: 1.09-1.44, P=0.001). The DFS (HR=0.97, 95%CI: 0.72-1.30, P=0.830) and LRRFS (HR=1.11, 95%CI: 0.93-1.34, P=0.250) presented no significant difference between two groups. Conclusion In TNBC, BCS was superior to mastectomy in the OS, so BCS is recommended to the patients who meet the indications. Key words: Breast neoplasms; Surgery; Disease-free survival; Meta-analysis; Overall survival; Local-regional recurrence-free survival; Triple negative breast cancer