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. 2022 Apr 14:12:848187.
doi: 10.3389/fonc.2022.848187. eCollection 2022.

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

Shouyu Li  1   2 , Yuting Zhao  1   2 , Lutong Yan  1   2 , Zejian Yang  1   2 , Pei Qiu  1   2 , Heyan Chen  1   2 , Yudong Zhou  1   2 , Ligang Niu  1 , Yu Yan  1 , Wei Zhang  1 , Huimin Zhang  1 , Jianjun He  1 , Can Zhou  1
Affiliations

Effect of the Nipple-Excising Breast-Conserving Therapy in Female Breast Cancer: A Competing Risk Analysis and Propensity Score Matching Analysis of Results Based on the SEER Database

Shouyu Li et al. Front Oncol. .

Abstract

Introduction: Due to the lack of randomized controlled trial, the effectiveness and oncological safety of nipple-excising breast-conserving therapy (NE-BCT) for female breast cancer (FBC) remains unclear. We aimed to explore and investigate the prognostic value of NE-BCT versus nipple-sparing breast-conserving therapy (NS-BCT) for patients with early FBC.

Methods: In this cohort study, data between NE-BCT and NS-BCT groups of 276,661 patients diagnosed with tumor-node-metastasis (TNM) stage 0-III FBC from 1998 to 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching analysis, Kaplan-Meier, X-tile, Cox proportional hazards model, and competing risk model were performed to evaluate the effectiveness and oncological safety for patients in NE-BCT and NS-BCT groups.

Results: A total of 1,731 (0.63%) patients received NE-BCT (NE-BCT group) and 274,930 (99.37%) patients received NS-BCT (NS-BCT group); 44,070 subjects died after a median follow-up time of 77 months (ranging from 1 to 227 months). In the propensity score matching (PSM) cohort, NE-BCT was found to be an adversely independent prognostic factor affecting overall survival (OS) [hazard ratio (HR), 1.24; 95% CI, 1.06-1.45, p=0.0078]. Subjects in NE-BCT group had similar breast-cancer-specific survival (BCSS) (HR, 1.15; 95%CI, 0.88-1.52, p=0.30) and worse other-causes-specific death (OCSD) (HR, 1.217; 95%CI, 1.002-1.478, p=0.048<0.05) in comparison with those in the NS-BCT group.

Conclusions: Our study demonstrated that the administration of NE-BCT is oncologically safe and reliable and can be widely recommended in clinics for women with non-metastatic breast cancer.

Keywords: SEER database; breast-conserving therapy; competing risk model; female breast cancer; nipple areola complex.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Inclusion and exclusion criteria of the study population.
Figure 2
Figure 2
Kaplan–Meier survival analysis for NE-BCT and NS-BCT female breast cancer patients. (A) Overall survival curves in NE-BCT group and NS-BCT group. (B) Breast-cancer-specific survival curves in NE-BCT group and NS-BCT group.
Figure 3
Figure 3
Multivariate Cox regression model forest graph.
Figure 4
Figure 4
Cumulative incidence of breast-cancer-specific death (BCSD) and other causes of death (OCSD) in the NE-BCT and NS-BCT groups.
Figure 5
Figure 5
Kaplan–Meier survival analysis for NE-BCT and NS-BCT female breast cancer patients between 2010 and 2015. (A) Overall survival curves in the NE-BCT and NS-BCT groups. (B) Breast-cancer-specific survival curves in the NE-BCT and NS-BCT groups.
Figure 6
Figure 6
Multivariate Cox regression model forest graph between 2010 and 2015.
Figure 7
Figure 7
Cumulative incidence of breast-cancer-specific death (BCSD) and other causes of death (OCSD) in the NE-BCT and NS-BCT groups between 2010 and 2015.
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