Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database.

Abstract

Introduction:

Due to the lack of randomized controlled trial, the effectiveness and oncological safety of nipple-excising breast-conserving therapy (NE-BCT) for female breast cancer (FBC) remains unclear. We aimed to explore and investigate the prognostic value of NE-BCT versus nipple-sparing breast-conserving therapy (NS-BCT) for patients with early FBC.

Methods:

In this cohort study, data between NE-BCT and NS-BCT groups of 276,661 patients diagnosed with tumor-node-metastasis (TNM) stage 0-III FBC from 1998 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching analysis, Kaplan-Meier, X-tile, Cox proportional hazards model, and competing risk model were performed to evaluate the effectiveness and oncological safety for patients in NE-BCT and NS-BCT groups.

Results:

A total of 1,731 (0.63%) patients received NE-BCT (NE-BCT group) and 274,930 (99.37%) patients received NS-BCT (NS-BCT group); 44,070 subjects died after a median follow-up time of 77 months (ranging from 1 to 227 months). In the propensity score matching (PSM) cohort, NE-BCT was found to be an adversely independent prognostic factor affecting overall survival (OS) [hazard ratio (HR), 1.24; 95% CI, 1.06-1.45, p=0.0078]. Subjects in NE-BCT group had similar breast-cancer-specific survival (BCSS) (HR, 1.15; 95%CI, 0.88-1.52, p=0.30) and worse other-causes-specific death (OCSD) (HR, 1.217; 95%CI, 1.002-1.478, p=0.048<0.05) in comparison with those in the NS-BCT group.

Conclusions:

Our study demonstrated that the administration of NE-BCT is oncologically safe and reliable and can be widely recommended in clinics for women with non-metastatic breast cancer.

• Authors: Shouyu Li, Yuting Zhao, Lutong Yan, Zejian Yang, Pei Qiu, Heyan Chen, Yudong Zhou, Ligang Niu, Yu Yan, Wei Zhang, Huimin Zhang, Jianjun He, Can Zhou
• Journal: Frontiers in oncology (Front Oncol) Vol. 12 Pg. 848187 ( 2022) ISSN: 2234-943X [Print] Switzerland
• PMID: 35494069 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Li, Zhao, Yan, Yang, Qiu, Chen, Zhou, Niu, Yan, Zhang, Zhang, He and Zhou.