Publicação
Which real indications remain for mastectomy?
| Resumo: | The study of He et al. compared outcomes after breastconserving therapy including radiation therapy with mastectomy without radiation therapy, after preoperative systemic therapy for patients with early stage HER2- positive breast cancer.1 After a median follow-up of 9.9 years, breast-conserving therapy was associated with significantly higher overall survival compared to mastectomy (86.0% vs 79.3%; P = 0.02). This difference was significant for patients who had a pathological complete response in axillary lymph nodes (91.3% vs 83.5%, P = 0.02) and for those with a pathological complete response in the breast (93.4% vs 87.0%, P = 0.03), although the latter result was not significant in multivariable analysis. The authors hypothesise that the better survival outcomes after breast-conserving therapy may be explained by the impact of radiation therapy on the microenvironment, and/or that more extensive surgery negatively impacted on the immune response or directly caused local, vascular or lymphatic seeding. We fully agree that the interactions between surgery, radiation therapy, systemic treatments, and the immune environment require further research. |
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| Autores principais: | Cardoso, Maria-Joao |
| Outros Autores: | de Boniface, Jana; Dodwell, David; Kaidar-Person, Orit; Poortmans, Philip; van Maaren, Marissa C. |
| Ano: | 2024 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | The study of He et al. compared outcomes after breastconserving therapy including radiation therapy with mastectomy without radiation therapy, after preoperative systemic therapy for patients with early stage HER2- positive breast cancer.1 After a median follow-up of 9.9 years, breast-conserving therapy was associated with significantly higher overall survival compared to mastectomy (86.0% vs 79.3%; P = 0.02). This difference was significant for patients who had a pathological complete response in axillary lymph nodes (91.3% vs 83.5%, P = 0.02) and for those with a pathological complete response in the breast (93.4% vs 87.0%, P = 0.03), although the latter result was not significant in multivariable analysis. The authors hypothesise that the better survival outcomes after breast-conserving therapy may be explained by the impact of radiation therapy on the microenvironment, and/or that more extensive surgery negatively impacted on the immune response or directly caused local, vascular or lymphatic seeding. We fully agree that the interactions between surgery, radiation therapy, systemic treatments, and the immune environment require further research. |
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