University of Twente Student Theses
Non-inflammatory skin involvement (T4b) in breast cancer : time trends and the effect of breast-conserving surgery versus mastectomy on survival in The Netherlands
Haarman, W.L. (2023) Non-inflammatory skin involvement (T4b) in breast cancer : time trends and the effect of breast-conserving surgery versus mastectomy on survival in The Netherlands.
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| Abstract: | Background Non-inflammatory breast carcinomas with direct extension to the skin are considered locally advanced and classified as T4b (stage III). This population-based study aimed to analyse the characteristics, treatment and survival of T4b breast cancer over time and investigated the survival in T4b breast cancer after breast-conserving surgery (BCS) versus mastectomy, both as part of trimodality therapy, in the Netherlands. Methods All 5,829 women diagnosed with T4b breast cancer in 2005-2021 were selected from the Netherlands Cancer Registry. To analyse time trends, patients were divided into time cohorts based on their year of diagnosis: 2005-09, 2010-14, 2015-19, 2020-21. The effect on 10-year overall survival (OS) of T4b patients receiving BCS versus mastectomy, both as part of trimodality therapy (neoadjuvant systemic therapy, surgery, and adjuvant radiotherapy), was estimated using multivariable Cox proportional hazard analysis. Results In recent years, the number of mastectomies in T4b patients in the Netherlands has decreased, while the number of BCS has increased. In 2005-2021, 1,394 T4b patients received trimodality therapy, of which 1,214 (87.1%) received mastectomy and 180 (12.9%) received BCS. Multivariable Cox proportional hazard analysis revealed that there is no significant difference between mastectomy and BCS, both part of trimodality therapy, in terms of OS (HR: 0.67; 95% CI 0.38–1.19; p=0.171). Conclusion No significant association was found between type of surgical treatment (mastectomy versus BCS) and OS in T4b patients in the Netherlands. These results suggest that BCS is a sufficient treatment option over mastectomy when both surgical techniques are appropriate. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/94294 |
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