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ePoster Display

163P - Is breast-conserving surgery safe in young African breast cancer patients?

Date

16 Sep 2021

Session

ePoster Display

Topics

Tumour Site

Breast Cancer

Presenters

Abeid Athman Omar

Citation

Annals of Oncology (2021) 32 (suppl_5): S407-S446. 10.1016/annonc/annonc687

Authors

A.M. Athman Omar1, A.M..A. Darwesh1, O. Hamid2, O. Shebl Zahra1, A. Belal1

Author affiliations

  • 1 Clinical Oncology And Nuclear Medicine Department, Faculty of Medicine, Alexandria University, 20 - Alexandria/EG
  • 2 Oncology Department, CSU - Central South University - Xiangya School of Medicine - New Campus, 410013 - Changsha/CN
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Abstract 163P

Background

There is conflicting data that breast conservative surgery (BCS) is associated with higher locoregional recurrences (LRR) than mastectomy in young breast cancer patients (BCY). However, there is little data from the African population.

Methods

Women aged ≤40 with stage I-III BC, diagnosed in 2008 - 2017 in two Alexandria centres, Egypt, were retrospectively reviewed. We compared the clinicopathological characteristics, treatment, LRR and local recurrence-free survival (LRFS) between patients who underwent mastectomy vs BCS.

Results

Out of the nine hundred and twenty patients included in this analysis, 33% (307) underwent BCS. The mean age at diagnosis was 35.15 years (SD ± 4.3) and was similar in both groups. The table summarises the clinicopathological characteristics of the mastectomy and BCS group. The patients who underwent mastectomy had significantly more T3/T4 tumours and positive lymph nodes (N+), while those who underwent BCS had more grade 3 tumours. The receptor expression (ER, PR, HER2), Ki-67 and the timing of chemotherapy were comparable across the groups. All the BCS patients were irradiated, whereas, in the mastectomy group, T3/T4 and/or N+ patients were irradiated. After a median follow up of 41 months (Range: 1-143), the LRR was similar in both groups: 10% (61) in the mastectomy group and 12% (38) in the BCS group; p=0.263. There was no significant difference in the mean LRFS between the two groups, 124 vs 112 months in mastectomy and BCS groups, respectively; HR 0.835 (95% CI: 0.557 – 1.253, p=0.383). Table: 163P

Clinicopathological characteristics and treatment of the mastectomy vs BCS

Variable Mastectomy BCS P value
n % n %
T-size (n=848)T1/T2T3/T4 422139 75.224.8 26522 92.37.7 <0.001
N-status (n=881)N0N+ 1-3N+ ≥4 146162278 24.927.647.4 1349269 45.5 31.2 23.4 <0.001
Focality (n=902)UnifocalMultifocal 464136 77.322.7 25052 82.8 17.2 0.57
Molecular subtype (n=855)ER/PR positiveHER2 enrichedTNBC 4643956 83.07.010 2351744 79.45.714.9 0.098
Ki-67 (n=143)<20≥20 2743 38.664.4 2449 32.9 67.1 0.477
Tumour Grade (n=855)IIIIII 1246491 2.181.816.0 1220373 4.270.5 25.3 0.001
Chemotherapy Timing (n=886)NAC onlyAdjuvant OnlyBoth 3951645 6.586.07.5 2224915 7.787.15.2 0.391
BRCA status Unknown Not done Unknown Not done N/A

Conclusions

To our knowledge, this is one of the largest studies of young breast cancer patients in Africa comparing the local failure after mastectomy and BCS. In this large study, breast-conserving surgery was not detrimental to locoregional control in young African breast cancer patients and should be considered whenever feasible and discussed with patients for a joint decision.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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