Occult breast cancer patients with mastectomy have better prognosis than those with breast-conserving therapy

Background: This single-center retrospective study compared the efficacy of breast-conserving therapy along with axillary lymph node dissection (ALND) with mastectomy and ALND with regard to survival of Chinese patients with occult breast cancer. Materials & methods: Univariate Kaplan-Meier analysis and multivariate Cox proportional hazards model were used to compare treatments and prognosis. Results: A total of 111 patients with a median follow-up of 72.9 months were included. 39 patients with mastectomy + ALND had better disease-free survival than 72 patients with breast-conserving therapy + ALND (HR = 0.31; p = 0.012). Patients with radiotherapy demonstrated inferior survival for both overall survival (HR = 2.67; p = 0.071) and disease-free survival (HR = 5.35; p = 0.002). Surgical strategies and radiotherapy remained significantly predictive of better disease-free survival in multivariate analyses. Conclusion: Mastectomy and ALND demonstrate superior disease-free prognosis compared with breast-conserving therapy and ALND in occult breast cancer.