Table 1. Studies comparing outcomes for Breast Conservation Treatment & Mastectomy

Author/ Year of publicationCentre/CountryTreatment periodNo. of patientsType of studyComparison of survivalComparison of Local controlBCT rateConclusion & Relevant Comments
         
Hwang et al.12 2013Duke University, USA1990-2004112,154 Stage I,IIRetrospective California Cancer RegistryHR for OS BCS+RT: 0.72 (0.68-0.76) Mx:          1.0  NR55 %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 2014University of Michigan, USA1998-2008132,149 <4cm <4 LN+Retrospective, SEERHR for survival  (p<0.001) BCS+RT: 1.0 Mx:         1.31 (1.25-1.39)                                  Mx+RT:  1.47 (1.34-1.61)NR70%Patients with BCT improved breast cancer specific survival  
van Hezewijk et al14 2013Multicentre trial, various countries (TEAM trial)2001-20069231 ER,PR+veProspectiveHR 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 2007Australian National University1995-19992787RetrospectiveHazard of death reduced by 55.88%NR51.5%Patients with BCS better survival than mastectomy
Horvind et al.19 2015Cancer Registry of Norway2005-20119547Retrospective Norway RegistryHR of death at 6 yrs BCT: 1.0 Mx:    1.7 (1.3-2.4)NR61.1%Women treated with BCT have significantly better breast cancer-specific survival
Saadatmand et al25  2015Erasmus University Medical Centre1999-2012173,797Retrospective The Netherlands Cancer RegistryHR for 5 yr overall mortality BCT: 0.87 (95%CI 0.81-0.93) Mx:   1.0 (Reference)NR48% (‘99-‘05) 54% (’06-’12)Comparison of 2 cohorts of patients from 1999-2005 & 2006-2012
van der Heiden-van der Loo et al21 2015Netherlands Comprehensive Cancer Organisation2003-200640,892Retrospective The Netherlands Cancer RegistryNR5-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  2016Netherlands Comprehensive Cancer Organisation2000-200437,207Retrospective The Netherlands Cancer RegistryHR for 10-yr overall mortality BCT: 0.81 (95%CI 0.78-0.85) Mx:   1.0 (Reference)NR58%Significantly higher 10 year distant metastasis-free survival for BCS + RT in T1N0 stage cancer
Plichta et al23 2016Massachusetts General Hospital1996-2008584 <40 yrs oldRetrospective Single centre10 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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