Segmental mastectomy without radiotherapy. Short-term follow-up

Area of Science:

• Oncology
• Surgical Oncology

Background:

• Segmental mastectomy and total mastectomy are surgical options for early-stage operable breast cancer.
• Radiation therapy is often used after segmental mastectomy, but this study excluded its use.

Purpose of the Study:

• To compare short-term treatment failures between segmental mastectomy and total mastectomy for primary operable breast cancer Stages I and II.
• To evaluate the impact of resection margin involvement on local recurrence rates.

Main Methods:

• A retrospective comparison of 43 segmental mastectomies and 157 total mastectomies for Stages I-II breast cancer.
• Patients had similar demographics and tumor characteristics; no radiation therapy was administered.
• A serial subgross technique was used to assess resection margins for microscopic carcinoma foci.

Main Results:

• Overall recurrence rates were 19% for segmental mastectomy versus 5% for total mastectomy (average follow-up 24 months).
• For tumors 11-50 mm, recurrence rates were 28.0% for segmental mastectomy and 7.5% for total mastectomy.
• Local recurrence was significantly higher in the segmental mastectomy group (P < 0.005).
• Microscopic involvement of resection margins was a significant predictor of local recurrence.

Conclusions:

• Segmental mastectomy without radiation therapy is associated with a higher short-term recurrence rate, primarily due to local recurrence, compared to total mastectomy.
• Careful assessment of resection margins is crucial for predicting local recurrence risk in breast cancer surgery.