Survival after Breast-Conserving Therapy vs Mastectomy Among
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Whether patients with breast cancer who carry a BRCA1/2 variant can safely undergo breast-conserving therapy (BCT) remains unclear. The JAMA Surgery research states that BCT may be an option for patients who carry a BRCA1/2 variant when the tumor is clinically appropriate for this procedure.

The study was carried out to compare survival rates after BCT vs mastectomy in BRCA1/2 variant carriers and noncarriers in a large series of unselected patients with breast cancer.

In this cohort study, a large consecutive series of 8396 unselected patients with primary breast cancer who underwent either BCT, mastectomy with radiotherapy, or mastectomy alone in China were included. All patients were assessed for BRCA1/2 germline variant status.

Of these 8396 Chinese patients, 3135 received BCT, 1511 received mastectomy with radiotherapy, and 3750 received mastectomy alone. The outcomes were;

--After a median follow-up of 7.5 years, both BRCA1 and BRCA2 variant carriers treated with BCT had similar rates of survival compared with those treated with mastectomy with radiotherapy or mastectomy alone after adjusting for clinicopathologic factors and adjuvant therapy.

--For noncarriers, patients receiving BCT had significantly better survival than those receiving mastectomy with radiotherapy or mastectomy alone in multivariable analyses.

This study suggests that BRCA1/2 variant carriers treated with BCT have survival rates at least comparable to those treated with mastectomy with radiotherapy or mastectomy alone and that BCT could be an option for BRCA1/2 variant carriers when the tumor is clinically appropriate for BCT.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779054
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