The Role of Age on Distant Recurrence After Breast Conservative Therapy Vs. Modified Radical Mastectomy Among Iranian Patients With Early Stage of Breast Cancer Publisher



Shamsi F¹ ; Reza Baghestani A² ; Akhavan A³ ; Bastani P⁴ Show Affiliations
Source: World Cancer Research Journal Published:2020

Abstract

– Objective: Breast conserving therapy is highly recommended for the surgical management of patients with early-stage of breast cancer. This study aimed to explore the effect of age on developing distant metastasis following breast conserving therapy or modified radical mastectomy. Patients and Methods: To this aim, medical records of 468 women diagnosed with T1-2, N0-1, and M0 primary invasive breast cancer during 2005-2012 were selected. Patients were treated with either breast conserving therapy or modified radical mastectomy with post-surgical radiation. Kaplan-Meier method was used to estimate the breast cancer-free survival and distant metastatic-free survival rates. Distant metastasis and prognostic factors were modeled by Cox proportional hazards. The Bayesian approach was used to determine the po-tential threshold of patients’ age at operation and the cure probabilities were estimated through two treat-ment types according to age change-point. Results: There was no significant difference in Locoregional recurrence between two treatments type (p=0.83), although a significantly greater recurrence of distant metastasis was observed in the breast conserving therapy group (p<0.001). Considering metastatic-free survival, the age of 40 was estimated as the change-point of age at operation leading to a higher noticeable cure rate in the modified radical mastectomy group. Conclusions: Older patients with early-stage of breast cancer treated with modified radical mastectomy had a significant decrease of distant metastasis compared with younger patients with a threshold of 40 for age at operation. © 2020, Verduci International. All rights reserved.