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Table 1. Studies comparing outcomes for Breast Conservation Treatment & Mastectomy
| Author/ Year of publication | Centre/Country | Treatment period | No. of patients | Type of study | Comparison of survival | Comparison of Local control | BCT rate | Conclusion & Relevant Comments |
| Hwang et al.12 2013 | Duke University, USA | 1990-2004 | 112,154 Stage I,II | Retrospective California Cancer Registry | HR for OS BCS+RT: 0.72 (0.68-0.76) Mx: 1.0 | NR | 55 % | BCS+RT associated with higher breast cancer specific survival at almost 10-yr follow up For every potential confounding factor related to mortality evaluated, women with Mx more likely to die with 3 yrs |
| Agarwal et al.13 2014 | University of Michigan, USA | 1998-2008 | 132,149 <4cm <4 LN+ | Retrospective, SEER | HR for survival (p<0.001) BCS+RT: 1.0 Mx: 1.31 (1.25-1.39) Mx+RT: 1.47 (1.34-1.61) | NR | 70% | Patients with BCT improved breast cancer specific survival |
| van Hezewijk et al14 2013 | Multicentre trial, various countries (TEAM trial) | 2001-2006 | 9231 ER,PR+ve | Prospective | HR 5-yr OS: (p<0.001) BCS+RT: 1.0 Mx: 1.22 (1.02-1.47) | HR for LRR (p=0.01) BCS+RT 1.0 Mx 1.53 (1.10-2.11) | 54.1% | Significantly higher LRR in patients with Mx only |
| Martin et al.18 2007 | Australian National University | 1995-1999 | 2787 | Retrospective | Hazard of death reduced by 55.88% | NR | 51.5% | Patients with BCS better survival than mastectomy |
| Horvind et al.19 2015 | Cancer Registry of Norway | 2005-2011 | 9547 | Retrospective Norway Registry | HR of death at 6 yrs BCT: 1.0 Mx: 1.7 (1.3-2.4) | NR | 61.1% | Women treated with BCT have significantly better breast cancer-specific survival |
| Saadatmand et al25 2015 | Erasmus University Medical Centre | 1999-2012 | 173,797 | Retrospective The Netherlands Cancer Registry | HR for 5 yr overall mortality BCT: 0.87 (95%CI 0.81-0.93) Mx: 1.0 (Reference) | NR | 48% (‘99-‘05) 54% (’06-’12) | Comparison of 2 cohorts of patients from 1999-2005 & 2006-2012 |
| van der Heiden-van der Loo et al21 2015 | Netherlands Comprehensive Cancer Organisation | 2003-2006 | 40,892 | Retrospective The Netherlands Cancer Registry | NR | 5-yr IBTR BCS (+RT): 2.38 % Mx: 3.45 % | 54.9% | IBTR rates may be used as an outcome indicator on a national level for international comparison |
| van Maaren et al.24 2016 | Netherlands Comprehensive Cancer Organisation | 2000-2004 | 37,207 | Retrospective The Netherlands Cancer Registry | HR for 10-yr overall mortality BCT: 0.81 (95%CI 0.78-0.85) Mx: 1.0 (Reference) | NR | 58% | Significantly higher 10 year distant metastasis-free survival for BCS + RT in T1N0 stage cancer |
| Plichta et al23 2016 | Massachusetts General Hospital | 1996-2008 | 584 <40 yrs old | Retrospective Single centre | 10 year DFS BCT: 89% Mx: 79% | 10 year LRR BCT: 4% Mx: 8.7% | 57.4% | BCT oncologically safe for young breast cancer patients |
BCS: Breast Conserving Surgery/lumpectomy only; BCT: Breast Conservation Treatment/Lumpectomy with radiotherapy; DFS: disease-free survival; ER: oestrogen receptors; HR: Hazard ratio; IBTR: Ipsilateral Breast Tumour Recurrence; LN: lymph node status; LR: local recurrence; Mx: Mastectomy; NR: Not Reported; OS: overall survival; PR: progesterone receptors; RT: Radiotherapy/Radiation treatment; SEER: Surveillance Epidemiology, and End Results database; TEAM: Tamoxifen Exemestane Adjuvant Multicentre trial; USA: United States of America
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