Contralateral Prophylactic Mastectomy Improves Survival Only Marginally in Patients with Unilateral Triple-Negative Breast Cancer: A Cohort Study Based on SEER Database

Pengcheng Yang, Yuxin Chu, Qian Li, Tianyu Lei, Jia Song, Tingting Ning and Qinyong Hu

Cancer Center, Renmin Hospital of Wuhan University, China

^*Correspondance to: Qinyong Hu 

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Abstract:

Background: The effect of Contralateral Prophylactic Mastectomy (CPM) on the survival rate of Triple-Negative Breast Cancer (TNBC) patients is still controversial. The purpose of this study was to confirm whether unilateral TNBC patients benefit from CPM.
Methods: 10,006 patients with unilateral TNBC in the Surveillance, Epidemiology and End Results (SEER) database were enrolled in this study; Propensity Score Matching (PSM) was applied to balance patient assignments. After PSM, 3,039 pairs of patients were divided into a CPM group and no-CPM group, respectively. All the patients have undergone total mastectomy or radical mastectomy. Cox proportional hazards regression models were used to evaluate Overall Survival (OS) and Breast
Cancer-Specific Survival (BCSS) of the two groups. Subgroup analysis was introduced to exclude the effect of confounding factors. To identify potential variables for prognosis, Kaplan-Meier survival analysis and Cox regression analysis were used and were presented by Kaplan-Meier curve and forest plot separately.
Results: With a median follow-up time of 34.5 months (IQR 1 to 83 months), the estimated 5-year BCSS rates for patients in the CPM group and the no-CPM group were 81.96% and 78.71%, the 5-year OS rates were 80.10% and 75.05%, respectively. CPM improved the BCSS (hazard ratio [HR]=0.79; 95% confidence interval [CI] =0.69-0.90, p=0.001) and OS (HR=0.74; 95% CI=0.66-0.84, p<0.001) of unilateral TNBC patients. Univariate subgroup analyses revealed that there was no significant difference in survival time for patients in stage N3 who underwent CPM or not (p>0.05).
Conclusion: CPM only limitedly improved BCSS and OS in patients with unilateral TNBC undergoing total mastectomy or radical mastectomy and was not recommended for stage N3 patients.

Keywords:

Breast neoplasms; Prophylactic mastectomy; Survival analysis; Triple negative breast neoplasms

Cite the Article:

Yang P, Chu Y, Li Q, Lei T, Song J, Ning T, et al. Contralateral Prophylactic Mastectomy Improves Survival Only Marginally in Patients with Unilateral Triple-Negative Breast Cancer: A Cohort Study Based on SEER Database. Clin Oncol. 2021;6:1868..