Prognosis after mastectomy versus repeat lumpectomy in patients with ipsilateral breast cancer recurrence: A propensity score analysis

A. Yoshida, O. Takahashi, Y. Okumura, N. Arima, K. Nakatsukasa, M. Tanabe, Tadahiko Shien, N. Masuda, S. Tanaka, Y. Komoike, T. Taguchi, T. Iwase, R. Nishimura, H. Inaji, H. Yamauchi, M. Ishitobi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Introduction Mastectomy is the current standard surgical procedure for ipsilateral breast tumor recurrence (IBTR). However, there is little evidence about the prognostic impact of the surgical procedure (mastectomy versus repeat lumpectomy) for IBTR. Patients and methods A total of 271 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent definitive surgery for IBTR between 1989 and 2008 were included from eight institutions in Japan. The impact of the surgical procedure for IBTR on distant disease-free survival (DDFS) and overall survival (OS) was evaluated using and multivariable proportional hazards regression and propensity score matching methods. Results Of the 271 patients, 149 patients (55%) underwent repeat lumpectomy and 122 patients (45%) underwent mastectomy after IBTR. The median follow-up period from definitive surgery for IBTR was 55 months. There was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR, adjusted for various clinical and tumor characteristics. In addition, for the matched patient cohort, no difference in DDFS and OS was seen between the 2 groups. Conclusion In our study, both multivariate analysis and the propensity score matching method demonstrated that there was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR. Further studies are warranted (UMIN-CTR number UMIN000008136).

Original languageEnglish
Pages (from-to)474-480
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume42
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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Propensity Score
Segmental Mastectomy
Mastectomy
Breast Neoplasms
Recurrence
Disease-Free Survival
Survival
Japan
Multivariate Analysis
Neoplasm Metastasis

Keywords

  • Breast cancer
  • Breast-conserving surgery
  • Ipsilateral breast tumor recurrence
  • Mastectomy
  • Propensity score
  • Repeat lumpectomy

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Prognosis after mastectomy versus repeat lumpectomy in patients with ipsilateral breast cancer recurrence : A propensity score analysis. / Yoshida, A.; Takahashi, O.; Okumura, Y.; Arima, N.; Nakatsukasa, K.; Tanabe, M.; Shien, Tadahiko; Masuda, N.; Tanaka, S.; Komoike, Y.; Taguchi, T.; Iwase, T.; Nishimura, R.; Inaji, H.; Yamauchi, H.; Ishitobi, M.

In: European Journal of Surgical Oncology, Vol. 42, No. 4, 01.04.2016, p. 474-480.

Research output: Contribution to journalArticle

Yoshida, A, Takahashi, O, Okumura, Y, Arima, N, Nakatsukasa, K, Tanabe, M, Shien, T, Masuda, N, Tanaka, S, Komoike, Y, Taguchi, T, Iwase, T, Nishimura, R, Inaji, H, Yamauchi, H & Ishitobi, M 2016, 'Prognosis after mastectomy versus repeat lumpectomy in patients with ipsilateral breast cancer recurrence: A propensity score analysis', European Journal of Surgical Oncology, vol. 42, no. 4, pp. 474-480. https://doi.org/10.1016/j.ejso.2016.01.011
Yoshida, A. ; Takahashi, O. ; Okumura, Y. ; Arima, N. ; Nakatsukasa, K. ; Tanabe, M. ; Shien, Tadahiko ; Masuda, N. ; Tanaka, S. ; Komoike, Y. ; Taguchi, T. ; Iwase, T. ; Nishimura, R. ; Inaji, H. ; Yamauchi, H. ; Ishitobi, M. / Prognosis after mastectomy versus repeat lumpectomy in patients with ipsilateral breast cancer recurrence : A propensity score analysis. In: European Journal of Surgical Oncology. 2016 ; Vol. 42, No. 4. pp. 474-480.
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abstract = "Introduction Mastectomy is the current standard surgical procedure for ipsilateral breast tumor recurrence (IBTR). However, there is little evidence about the prognostic impact of the surgical procedure (mastectomy versus repeat lumpectomy) for IBTR. Patients and methods A total of 271 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent definitive surgery for IBTR between 1989 and 2008 were included from eight institutions in Japan. The impact of the surgical procedure for IBTR on distant disease-free survival (DDFS) and overall survival (OS) was evaluated using and multivariable proportional hazards regression and propensity score matching methods. Results Of the 271 patients, 149 patients (55{\%}) underwent repeat lumpectomy and 122 patients (45{\%}) underwent mastectomy after IBTR. The median follow-up period from definitive surgery for IBTR was 55 months. There was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR, adjusted for various clinical and tumor characteristics. In addition, for the matched patient cohort, no difference in DDFS and OS was seen between the 2 groups. Conclusion In our study, both multivariate analysis and the propensity score matching method demonstrated that there was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR. Further studies are warranted (UMIN-CTR number UMIN000008136).",
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T2 - A propensity score analysis

AU - Yoshida, A.

AU - Takahashi, O.

AU - Okumura, Y.

AU - Arima, N.

AU - Nakatsukasa, K.

AU - Tanabe, M.

AU - Shien, Tadahiko

AU - Masuda, N.

AU - Tanaka, S.

AU - Komoike, Y.

AU - Taguchi, T.

AU - Iwase, T.

AU - Nishimura, R.

AU - Inaji, H.

AU - Yamauchi, H.

AU - Ishitobi, M.

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N2 - Introduction Mastectomy is the current standard surgical procedure for ipsilateral breast tumor recurrence (IBTR). However, there is little evidence about the prognostic impact of the surgical procedure (mastectomy versus repeat lumpectomy) for IBTR. Patients and methods A total of 271 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent definitive surgery for IBTR between 1989 and 2008 were included from eight institutions in Japan. The impact of the surgical procedure for IBTR on distant disease-free survival (DDFS) and overall survival (OS) was evaluated using and multivariable proportional hazards regression and propensity score matching methods. Results Of the 271 patients, 149 patients (55%) underwent repeat lumpectomy and 122 patients (45%) underwent mastectomy after IBTR. The median follow-up period from definitive surgery for IBTR was 55 months. There was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR, adjusted for various clinical and tumor characteristics. In addition, for the matched patient cohort, no difference in DDFS and OS was seen between the 2 groups. Conclusion In our study, both multivariate analysis and the propensity score matching method demonstrated that there was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR. Further studies are warranted (UMIN-CTR number UMIN000008136).

AB - Introduction Mastectomy is the current standard surgical procedure for ipsilateral breast tumor recurrence (IBTR). However, there is little evidence about the prognostic impact of the surgical procedure (mastectomy versus repeat lumpectomy) for IBTR. Patients and methods A total of 271 consecutive patients who had histologically confirmed IBTR without distant metastases and underwent definitive surgery for IBTR between 1989 and 2008 were included from eight institutions in Japan. The impact of the surgical procedure for IBTR on distant disease-free survival (DDFS) and overall survival (OS) was evaluated using and multivariable proportional hazards regression and propensity score matching methods. Results Of the 271 patients, 149 patients (55%) underwent repeat lumpectomy and 122 patients (45%) underwent mastectomy after IBTR. The median follow-up period from definitive surgery for IBTR was 55 months. There was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR, adjusted for various clinical and tumor characteristics. In addition, for the matched patient cohort, no difference in DDFS and OS was seen between the 2 groups. Conclusion In our study, both multivariate analysis and the propensity score matching method demonstrated that there was no difference in terms of DDFS and OS between repeat lumpectomy and mastectomy after IBTR. Further studies are warranted (UMIN-CTR number UMIN000008136).

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