Table 1.
Summary of study characteristics, treatments and clinical outcomes of primary studies comparing breast‐conserving surgery with mastectomy
| Reference Study interval and location NOS score | Cancers included FU (months)* | Group differences in CP | No of patients (MF; MC) Other treatments Pathology | Outcomes | ||
|---|---|---|---|---|---|---|
| BCS | Mastectomy | BCS‡ | Mastectomy | |||
| Nos et al. 32 1983–1989 France 1 centre NOS 4 | n.a. FU 101 (86–129) | Significant differences in age and T category | 56 (56; 0) Radiotherapy, chemotherapy, endocrine IDC 79%, ILC 13% | 132 Radiotherapy, chemotherapy, endocrine IDC 83%, ILC 8% | 5‐year LRR: 11% 10‐year LRR: 23% 5‐year DM: 18% 10‐year DM: 28% 5‐year OS: 94% 10‐year OS: 73% | 5‐year LRR: 11% 10‐year LRR: 14% 5‐year DM: 18% 10‐year DM: 35% 5‐year OS: 89% 10‐year OS: 65% |
| Kaplan et al. 33, † 1989–2002 USA 2 centres NOS 4 | MIBC, diagnosed before surgery FU 45 (1–143) | No significant differences | 36 Radiotherapy, chemotherapy, endocrine IDC 72%, ILC 19%, DCIS 8% | 19 Radiotherapy, chemotherapy, endocrine IDC 68%, ILC 21%, DCIS 11% | 5‐year LRR: 1 of 36 (3%) (P = 0.54) DM: 1 of 36 (3%) (P = 0·20) OS: 36 of 36 (100%) | 5‐year LRR: 0 of 19 (0%) DM: 1 of 19 (5%) OS: 19 of 19 (100%) |
| Lim et al. 34 1990–2003 South Korea 1 centre NOS 6 | MF FU 59 (1–177) Mastectomy: 65 (6–196) | HER2+ (P = 0·007) T2 (P = 0·006) | 147 (147; 0) Radiotherapy, endocrine IDC 97%, ILC 3% | 331 Radiotherapy, endocrine IDC 96%, ILC 4% | 5‐year LRR: 3 of 147 (2.0%) (P = 0·38) 5‐year DFS: 89% (P = 0·45) 5‐year OS: 93·4% (P = 0·21) | 5‐year LRR: 3 of 331 (0·9%) 5‐year DFS: 92% 5‐year OS: 94·5% |
| Kadioğlu et al. 35 2002–2011 Turkey 1 centre NOS 5 | MF, diagnosed by histology FU 55 (10–102) | No. of foci (P = 0·001) LVI (P = 0·04) LN positivity (P = 0·002) TNM stage (P = 0·01) HER2+ (P = 0·03) | 119 (119; 0) Radiotherapy, chemotherapy, endocrine IDC 71%, ILC 12% | 103 Radiotherapy, chemotherapy, endocrine IDC 69%, ILC 8% | 5‐year LRR: 6 of 119 (5·0%) (P = 0·06) 5‐year OS: 92%, median 95 (range 91–99) months (P < 0·001) | 5‐year LRR: 6 of 103 (5·8%) 5‐year OS: 72%, median 73 (range 68–78) months |
| Neri et al. 20, † Italy 1991–2005 1 centre NOS 7 | MF diagnosed before surgery FU 88 (11–248) | n.a. | 36 (36; 0) Radiotherapy, chemotherapy endocrine | 155 Radiotherapy, chemotherapy, endocrine | 7‐year LR: 3 of 36 (8%) 7‐year LLR: 5 of 36 (14%) 7‐year RR: 2 of 36 (6%) DM: 7 of 36 (19%) | 7‐year LR: 12 of 155 (7·7%) 7‐year LLR: 23 of 155 (14·8%) 7‐year RR: 11 of 155 (7·1%) DM: 42 of 155 (27·1%) |
| Yerushalmi et al. 43, † 1989–2005 South Korea 5 regional centres NOS 7 | MIBC, diagnosed before surgery FU 93 | T, N category (P < 0·001) EIC (P < 0·001) Positive margins (P < 0·001) | 300 Radiotherapy, chemotherapy, endocrine IDC 88%, ILC 12% | 887 Radiotherapy, chemotherapy, endocrine IDC 92%, ILC 6% | 17 of 300 (5·7%) | 58 of 887 (6·5%) |
Values are mean (range). All studies were retrospective;
prospective database.
P values are for comparison of breast‐conserving surgery (BCS) versus mastectomy. NOS, Newcastle–Ottawa Scale; FU, follow‐up; CP, clinical pathology; MF, multifocal; MC, multicentric; n.a., not available; IDC, invasive ductal cancer; ILC, invasive lobular cancer; LRR, locoregional recurrence; DM, distant metastasis; OS, overall survival; MIBC, multiple ipsilateral breast cancers; DCIS, preinvasive ductal cancer in situ; HER2, human epidermal growth factor receptor 2; T2, tumour size 20–50 mm; DFS, disease‐free survival; LVI, lymphovascular invasion; LN, lymph node; LR, local recurrence; RR, regional recurrence; EIC, extensive preinvasive cancer or DCIS. Further details of the studies can be found in Tables S1–S3 (supporting information).