Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2025 Mar 16;15(1):9032.
doi: 10.1038/s41598-025-93491-7.

Oncological outcomes of breast-conserving surgery versus mastectomy following neoadjuvant chemotherapy in a contemporary multicenter cohort

Francisco Pimentel Cavalcante  1   2 , Felipe Pereira Zerwes  3 , Ryane Alcantara  4 , Eduardo Camargo Millen  5 , Andre Mattar  6 , Marcelo Antonini  7 , Anne Dominique Nascimento Lima  8 , José Bines  9 , Fabrício Palermo Brenelli  10 , Guilherme Garcia Novita  11 , Anastacio Berretini Junior  12 , Rafael Henrique Szymanski Machado  13 , Alessandra Borba Anton DE Souza  3 , Danielle Calheiros Campelo  14 , Rene Aloisio da Costa Vieira  15   16 , Antônio Luiz Frasson  17
Affiliations
Comparative Study

Oncological outcomes of breast-conserving surgery versus mastectomy following neoadjuvant chemotherapy in a contemporary multicenter cohort

Francisco Pimentel Cavalcante et al. Sci Rep. .

Abstract

To evaluate local recurrence (LR), distant recurrence (DR) and death in non-metastatic patients undergoing breast-conserving surgery (BCS) or mastectomy following current neoadjuvant chemotherapy (NAC) regimens. Patients submitted to NAC in 2013-2023 were evaluated (n = 365; mastectomy: 165; BCS: 200). More mastectomy patients were over 70 years old (12.7% versus 7%; p = 0.02) and had T4b tumors (16.4% versus 4.5%; p = 0.0003), whereas more BCS patients had node-negative axilla (42% versus 31.5%; p = 0.02). After a mean follow-up of 65 months (range: 4-124), LR and DR were similar in the mastectomy and BCS groups (4.8% versus 5.0%; p = 0.95 and 10.9% versus 9%; p = 0.58, respectively). More deaths occurred in the mastectomy group (8.5% versus 3%; p = 0.03). Ten-year LR-free survival was higher in the BCS group (98.5% versus 95%; HR: 3.41; 1.09-10.64; p = 0.03), while 10-year DR-free survival was similar in both groups (91% BCS versus 89% mastectomy, HR: 1.25; 0.65-2.42; p = 0.4). Overall survival was better in the BCS group (97% versus 91.5%; HR: 2.62; 1.06-6.69; p = 0.03). Estimated 10-year disease-free survival, stratified according to tumor stage, showed no significant difference except for T4 disease, for which the risk was greater in the mastectomy group (94.5% versus 81.8%; HR: 2.86, 1.54-5.30, p = 0.0008). In the multivariate analysis, T3/T4 staging (OR: 4.37, 1.03-21.91; p = 0.04) and axillary dissection (OR: 5.11, 1.14-35.52; p = 0.04) were associated with LR in the BCS group. In this cohort of patients receiving contemporary NAC, BCS proved to be a safe alternative to mastectomy following treatment with NAC, even in cases of locally advanced BC.

Keywords: Breast neoplasms; Chemotherapy; Locally advanced breast cancer; Mastectomy; Neoadjuvant therapy; Segmental mastectomy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Ten-year local recurrence-free survival rates in the BCS and mastectomy groups.
Fig. 2
Fig. 2
Ten-year distant recurrence-free survival rates in the BCS and mastectomy groups.
Fig. 3
Fig. 3
Ten-year overall survival rates in the BCS and mastectomy groups.
Fig. 4
Fig. 4
Ten-year disease-free survival rates according to tumor stage in the BCS and mastectomy groups.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Fisher, B. et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl. J. Med.347, 1233–1241. 10.1056/NEJMoa022152 (2002). - PubMed
    1. Veronesi, U. et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl. J. Med.347, 1227–1232. 10.1056/NEJMoa020989 (2002). - PubMed
    1. van Dongen, J. A. et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European organization for research and treatment of cancer 10801 trial. J. Natl. Cancer Inst.92, 1143–1150. 10.1093/jnci/92.14.1143 (2000). - PubMed
    1. Poggi, M. M. et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National cancer Institute randomized trial. Cancer98, 697–702. 10.1002/cncr.11580 (2003). - PubMed
    1. Blichert-Toft, M. et al. Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. J. Natl. Cancer Inst. Monogr. (11):19–25 (1992). - PubMed

LinkOut - more resources