Background:Breast-conserving surgery (BCS) is one of the major surgical advances in breast cancer treatment. This study evaluated the oncological outcomes of BCS in patients with non-metastatic breast cancer at a referral cancer center in a medium-resource country between 2013 and 2019.Methods:An observational, analytical, retrospective cohort study was conducted on patients with stage I–IIIC breast cancer treated at the Instituto Nacional de Cancerología (Bogotá, Colombia) from September 2013 to March 2019. Demographic data, tumor characteristics, treatment types, and survival outcomes were retrospectively collected.Results:A total of 409 patients were included. In 64.1% of cases, BCS was performed as the initial treatment and in 35.9%, after neoadjuvant chemotherapy (NACT). With a median follow-up of 85.2 months, tumor recurrence was documented in 9.04% of patients, local recurrence in 2.9%, regional in 2.2%, and distant in 5.6%. The identified risk factors for mortality were a locally advanced clinical stage (HR 5.13;p= 0.01), triple-negative subtype (HR 8.02;p< 0.01), and nodal involvement of more than four lymph nodes in the surgical specimen (HR 4.00;p< 0.01).Conclusions:Breast-conserving surgery is an oncologically safe procedure for patients with early and locally advanced breast cancer who respond to NACT. The time to recurrence and overall survival are determined by the clinical stage, axillary tumor burden, and biological subtype of the disease.
背景：保乳手术是乳腺癌治疗领域的一项重大外科进展。本研究评估了2013年至2019年间，在一个中等资源国家的转诊癌症中心对非转移性乳腺癌患者实施保乳手术的肿瘤学结局。 方法：本研究对2013年9月至2019年3月期间在哥伦比亚波哥大国家癌症研究所接受治疗的I–IIIC期乳腺癌患者进行了一项观察性、分析性、回顾性队列研究。回顾性收集了患者的人口统计学数据、肿瘤特征、治疗类型及生存结局。 结果：共纳入409例患者。其中64.1%的病例将保乳手术作为初始治疗，35.9%的病例在新辅助化疗后实施。中位随访时间为85.2个月，9.04%的患者出现肿瘤复发，其中局部复发率为2.9%，区域复发率为2.2%，远处转移率为5.6%。已确定的死亡风险因素包括局部晚期临床分期（风险比5.13；p=0.01）、三阴性亚型（风险比8.02；p<0.01）以及手术标本中超过4个淋巴结受累（风险比4.00；p<0.01）。 结论：对于对新辅助化疗有反应的早期及局部晚期乳腺癌患者，保乳手术是一种肿瘤学上安全的治疗方式。复发时间和总生存期取决于疾病的临床分期、腋窝肿瘤负荷及生物学亚型。
肿瘤(癌症)患者之家