Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis

BackgroundSalvage mastectomy (SM) is the standard surgery for ipsilateral breast tumour recurrence (IBTR). However, whether repeat breast-conserving surgery (RBCS) is an alternative method remains unclear. We performed a meta-analysis to compare the effects of RBCS and SM after IBTR for breast-conse...

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Autores principales:	Caiqin Mo, Weihong Ruan, Junyu Lin, Huaying Chen, Xiangjin Chen
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	meta-analysis repeat breast-conserving surgery salvage mastectomy ipsilateral breast tumor recurrence breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ad586fca749b42c9881b045f32ed1b4c
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spelling	oai:doaj.org-article:ad586fca749b42c9881b045f32ed1b4c2021-11-30T12:47:55ZRepeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis2234-943X10.3389/fonc.2021.734719https://doaj.org/article/ad586fca749b42c9881b045f32ed1b4c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.734719/fullhttps://doaj.org/toc/2234-943XBackgroundSalvage mastectomy (SM) is the standard surgery for ipsilateral breast tumour recurrence (IBTR). However, whether repeat breast-conserving surgery (RBCS) is an alternative method remains unclear. We performed a meta-analysis to compare the effects of RBCS and SM after IBTR for breast-conserving surgery (BCS).MethodsWe searched PubMed, Cochrane, Wiley Online and Embase for controlled studies comparing RBCS and SM after IBTR for BCS (published between 1993 and 2019, published in English). Our main endpoints were the secondary local recurrence rate (SLRR), distant metastasis rate (DMR) and overall survival (OS). We used a random-effects model or fixed-effects model for data pooling.ResultsFifteen of the 424 eligible studies were ultimately included, and all studies were retrospective cohort studies (n=2532 participants). 1) SLRR: The SLRR of RBCS was higher than SM (pooled relative rate (pRR) = 1.87, 95% CI 1.22 - 2.86, P=0.004). Stratified analysis was performed according to whether radiotherapy was performed after salvage surgery (radiotherapy group: 2ndRT, no radiotherapy group: no-2ndRT), and the following results were revealed: pRR=0.43 (95% CI 0.20-0.95, P=0.04) for group 2ndRT; and pRR=2.30 (95% CI 1.72-3.06, P<0.00001) for group no-2ndRT. These results showed that the main cause of heterogeneity was salvage radiotherapy. 2) DMR: No significant difference in the DMR was observed between RBCS and SM (pRR = 0.61, 95% CI 0.37 - 1.01, P=0.05). 3) OS: No significant difference in OS was observed between RBCS and SM (pRR=0.65, 95% CI 0.39 - 1.08, P=0.10).ConclusionsThe SLRR of RBCS was higher than SM for ITBR after BCS, but survival was not affected. RBCS may be used as an alternative for IBTR patients after BCS with strict control for several indications, such as tumor size, recurrence interval and biological behavior, and attaching importance to subsequent salvage radiotherapy and systematic therapy.Caiqin MoWeihong RuanJunyu LinHuaying ChenXiangjin ChenFrontiers Media S.A.articlemeta-analysisrepeat breast-conserving surgerysalvage mastectomyipsilateral breast tumor recurrencebreast cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	meta-analysis repeat breast-conserving surgery salvage mastectomy ipsilateral breast tumor recurrence breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	meta-analysis repeat breast-conserving surgery salvage mastectomy ipsilateral breast tumor recurrence breast cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Caiqin Mo Weihong Ruan Junyu Lin Huaying Chen Xiangjin Chen Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
description	BackgroundSalvage mastectomy (SM) is the standard surgery for ipsilateral breast tumour recurrence (IBTR). However, whether repeat breast-conserving surgery (RBCS) is an alternative method remains unclear. We performed a meta-analysis to compare the effects of RBCS and SM after IBTR for breast-conserving surgery (BCS).MethodsWe searched PubMed, Cochrane, Wiley Online and Embase for controlled studies comparing RBCS and SM after IBTR for BCS (published between 1993 and 2019, published in English). Our main endpoints were the secondary local recurrence rate (SLRR), distant metastasis rate (DMR) and overall survival (OS). We used a random-effects model or fixed-effects model for data pooling.ResultsFifteen of the 424 eligible studies were ultimately included, and all studies were retrospective cohort studies (n=2532 participants). 1) SLRR: The SLRR of RBCS was higher than SM (pooled relative rate (pRR) = 1.87, 95% CI 1.22 - 2.86, P=0.004). Stratified analysis was performed according to whether radiotherapy was performed after salvage surgery (radiotherapy group: 2ndRT, no radiotherapy group: no-2ndRT), and the following results were revealed: pRR=0.43 (95% CI 0.20-0.95, P=0.04) for group 2ndRT; and pRR=2.30 (95% CI 1.72-3.06, P<0.00001) for group no-2ndRT. These results showed that the main cause of heterogeneity was salvage radiotherapy. 2) DMR: No significant difference in the DMR was observed between RBCS and SM (pRR = 0.61, 95% CI 0.37 - 1.01, P=0.05). 3) OS: No significant difference in OS was observed between RBCS and SM (pRR=0.65, 95% CI 0.39 - 1.08, P=0.10).ConclusionsThe SLRR of RBCS was higher than SM for ITBR after BCS, but survival was not affected. RBCS may be used as an alternative for IBTR patients after BCS with strict control for several indications, such as tumor size, recurrence interval and biological behavior, and attaching importance to subsequent salvage radiotherapy and systematic therapy.
format	article
author	Caiqin Mo Weihong Ruan Junyu Lin Huaying Chen Xiangjin Chen
author_facet	Caiqin Mo Weihong Ruan Junyu Lin Huaying Chen Xiangjin Chen
author_sort	Caiqin Mo
title	Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
title_short	Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
title_full	Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
title_fullStr	Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
title_full_unstemmed	Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis
title_sort	repeat breast-conserving surgery versus salvage mastectomy for ipsilateral breast tumour recurrence after breast-conserving surgery in breast cancer patients: a meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ad586fca749b42c9881b045f32ed1b4c
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Repeat Breast-Conserving Surgery Versus Salvage Mastectomy for Ipsilateral Breast Tumour Recurrence After Breast-Conserving Surgery in Breast Cancer Patients: A Meta-Analysis

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