Purpose: To compare the survival outcomes of early-stage breast cancer patients treated with breast-conserving therapy (BCT) and mastectomy. Method: This retrospective study includes 1330 early-stage breast cancer patients treated at Chiang Mai University (CMU) hospital, using data from the Chiang Mai Cancer Registry between 2004 and 2015. Information pertinent to patients and their treatment was collected for analysis. Time-to-event analysis was performed using Kaplan–Meier methods. Results: The baseline characteristics of 1330 patients showed significant differences between the BCT and mastectomy groups in terms of age, tumor size, and tumor location. BCT patients were younger, had smaller tumors, and exhibited less nodal involvement. Propensity score matching created a balanced cohort of 534 patients where differences persisted in age and tumor size. Univariate analysis revealed significant survival associations for BCT, younger age, and smaller tumor size. Multivariate analysis confirmed these factors, with BCT showing an adjusted hazard ratio (HR) of 0.58 (95% CI: 0.36–0.93;p= 0.023) compared to mastectomy. Kaplan–Meier survival analysis demonstrated a significant survival advantage for BCT, particularly in HER2-enriched and triple-negative subtypes. The 15-year overall survival was 80.01% in the BCT group versus 64.33% in the mastectomy group (p< 0.001). Conclusions: This study reveals key differences between outcomes following breast-conserving therapy (BCT) and mastectomy patients, including age and tumor characteristics. BCT showed improved overall survival, particularly in HER2-enriched and triple-negative breast cancers. However, our study’s limitations may affect the results. These findings suggest that BCT may offer survival benefits for specific subtypes, highlighting the importance of personalized treatment approaches.
目的：比较早期乳腺癌患者接受保乳治疗与乳房切除术的生存结局。方法：本研究为回顾性分析，纳入清迈大学医院2004年至2015年间收治的1330例早期乳腺癌患者，数据来源于清迈癌症登记系统。收集患者临床特征及治疗信息进行分析，采用Kaplan-Meier法进行时间-事件分析。结果：1330例患者的基线特征显示，保乳治疗组与乳房切除术组在年龄、肿瘤大小及肿瘤位置方面存在显著差异。保乳治疗组患者更年轻、肿瘤更小、淋巴结转移率更低。经倾向评分匹配后获得534例平衡队列，两组在年龄与肿瘤大小方面差异仍持续存在。单因素分析显示保乳治疗、年轻年龄及较小肿瘤体积与生存率显著相关。多因素分析证实这些因素具有独立预测价值，其中保乳治疗的校正风险比（HR）为0.58（95% CI：0.36-0.93；p=0.023）。Kaplan-Meier生存分析表明保乳治疗组具有显著生存优势，尤其在HER2富集型及三阴性亚型中更为明显。保乳治疗组15年总生存率达80.01%，显著高于乳房切除术组的64.33%（p<0.001）。结论：本研究揭示了保乳治疗与乳房切除术患者在年龄、肿瘤特征及预后方面的关键差异。保乳治疗显示出更优的总生存率，特别是在HER2富集型及三阴性乳腺癌亚型中。但研究局限性可能影响结果解读。这些发现提示保乳治疗可能为特定亚型患者带来生存获益，凸显了个体化治疗方案的重要性。
肿瘤(癌症)患者之家