JAMA Surg: A long-term prognostic study of minimally invasive breast surgery in patients with early-stage breast cancer

According to the 2020 Global Cancer Statistics Report, there are an estimated 19.
3 million new cancer cases worldwide each year, of which 9.
23 million are women and 2.
26 million are women with new breast cancer
.
Breast cancer has overtaken lung cancer as the most common tumor and is the fifth leading cause
of tumor-related death worldwide.
A meta-analysis of global and regional breast cancer survival rates showed that global breast cancer patients had overall survival rates of 92%, 75%, 73%, and 61%
at 1, 10 years, respectively.
Breast cancer requires a combination of surgery, combined with radiotherapy, chemotherapy, and endocrine targeted therapy
.

Over the past few decades, the focus of breast cancer surgery has shifted to maintaining the patient's body shape, function, and quality of life, resulting in an increasing
rate of minimally invasive breast surgery (MABS).
Researchers today examined the differences in long-term prognosis for
patients undergoing minimally invasive breast surgery compared to traditional breast surgery (CBS).

This single-center retrospective cohort study included 2412 adult women diagnosed with early-stage (stage 0 to III) breast cancer, who underwent unilateral breast surgery (MABS or CBS) between January 2004 and December 2017, and who had no history of
distant metastases or serious underlying disease.
The primary endpoint of the study was to collect and analyze demographic and tumor characteristics and long-term prognostic data
.

The mean age of the patients was 44 years, of whom 603 received MABS (289, 302, and 12 patients underwent endoscopy, endoscopic assisted or robotic-assisted surgery, respectively), and 1809 patients received CBS
.
The median follow-up was 84 months (93 months in the MABS group and 80 months in the CBS group).

The results showed no significant difference between groups in the main endpoint parameters: 10-year local recurrence-free survival (93.
3 versus 96.
3 percent; Risk ratio [HR], 1.
39), regional recurrence-free survival (95.
5 versus 96.
7 percent; HR, 1.
38), survival without distant metastasis (81.
0 versus 82.
0 percent; HR，0.
95）
。 The 5-year, 10-year and 15-year disease-free survival rates were 85.
9%, 72.
6% and 69.
1% in the MABS group and 85.
0%, 76.
6% and 70.
7% in the CBS group, respectively, with no significant difference between groups (HR: 1.
07).

The 5-year, 10-year, and 15-year overall survival rates were 92.
0%, 83.
7%, and 83.
0%, respectively, in the MABS group, and 93.
6%, 88.
7%, and 81.
0%, respectively, in the CBS group, with no significant difference between groups (HR: 1.
29).

Postoperative subgroup analysis showed no significant difference
in disease-free survival between groups.

It is believed that for patients with early-stage breast cancer, minimally invasive breast surgery has no significant difference in
the long-term prognosis after surgery compared with traditional breast surgery.
Minimally invasive breast surgery is a safe and viable alternative treatment
option in early-stage breast cancer patients.

Original source:

Andi Wan, MM et al.
Association of Long-term Oncologic Prognosis With Minimal Access Breast Surgery vs Conventional Breast Surgery，JAMA Surg，October 5, 2022.