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Long-term survival outcomes of repeat lumpectomy for ipsilateral breast tumor recurrence: a propensity score-matched analysis

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Abstract

Purpose

This study aimed to compare long-term survival outcomes of repeat lumpectomy with total mastectomy after ipsilateral breast tumor recurrence (IBTR) using propensity score matching (PSM).

Methods

We retrospectively analyzed patients with IBTR who had undergone initial breast-conserving surgery for breast cancer at our institution between January 1990 and December 2013. The Kaplan–Meier method and Cox proportional hazards model were used to compare survival rates between the two groups. PSM was performed using the following covariates: age at initial operation, initial T stage, N stage, hormone receptor status, human epidermal growth factor receptor 2 status, chemotherapy, radiotherapy, and IBTR tumor size.

Results

We enrolled 335 IBTR patients with a median follow-up of 126.6 months. No significant differences were observed in the 5-year overall survival (OS), breast cancer-specific survival (BCSS), OS after IBTR, and BCSS after IBTR and 10-year survival probability between the two groups in a multivariate analysis. After PSM, patients who had undergone repeat lumpectomy and total mastectomy (n = 90 in both groups) were included. No significant differences were observed in the 10-year OS (hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.49–2.39), BCSS (HR 0.83, 95% CI 0.35–1.95), OS after IBTR (HR 0.83, 95% CI 0.38–1.83), and BCSS after IBTR (HR 0.64, 95% CI 0.28–1.47) between the two groups.

Conclusions

No significant differences were observed in survival outcomes between patients with IBTR who underwent repeat lumpectomy or total mastectomy. Our results can be helpful in selecting the appropriate surgical method for IBTR.

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Acknowledgements

This study was supported by a grant (Elimination of Cancer Project Fund) from the Asan Cancer Institute of Asan Medical Center, Seoul (2017-1341).

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, Republic of Korea

    Soo Yeon Baek, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son, Sei-Hyun Ahn & Sae Byul Lee

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  1. Soo Yeon Baek
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Correspondence to Sae Byul Lee.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was waived because the study was based on retrospective clinical data.

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Baek, S.Y., Kim, J., Chung, I.Y. et al. Long-term survival outcomes of repeat lumpectomy for ipsilateral breast tumor recurrence: a propensity score-matched analysis. Breast Cancer Res Treat 185, 155–164 (2021). https://doi.org/10.1007/s10549-020-05932-8

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  • DOI: https://doi.org/10.1007/s10549-020-05932-8

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