This document summarizes a meta-analysis that compared breast conservation therapy (BCT) to mastectomy for the treatment of early-stage breast cancer. The meta-analysis included over 5,000 women from 9 randomized controlled trials. It found that mastectomy provided a statistically significant benefit in overall survival compared to BCT, particularly for tumors under 2cm in size. However, there was no significant difference in disease-free survival between the two treatments. The conclusion is that while mastectomy may provide a slight survival benefit compared to BCT for early-stage breast cancer, BCT is now an acceptable alternative after improvements in systemic therapy.

1. Anne
Saputra

2. INTRODUCTION
•Breast Ca -> leading cause of death females in the world
•512.900 deaths in 2012 (1)
•Insidence -> RISING, 25% all cancer cases
•Therapy GOLD STANDART -> Halsted radical
mastectomy (any size, type, age)
•Breast Conservation Therapy (BCT) : alternative to
mastectomy, in Early-stage Breast Cancer (EBC)
•BCT associated higher locoregional reccurence rate???
Torre LA, Bray F, et all. Global Cancer Statistics, 2012. CA Cancer J Clin 2(65):87-108

3. AIM?
To estimate more accurately the magnitude
of overall survival (OS) and dissease free
survival (DFS) benefits from mastectomy
and BCT for patients with early breast
cancer by meta-analysis using hazard ratio
(HR) statistic.

4. METHODS
1. Selection criteria: (PubMed, Embase, Web science, etc)
• RCT compared BCT Vs Mastectomy for EBC
• Pathologically confirmed EBC
• Availability of HR and 95 CI
2. Data extraction
3. Statistical : meta-analysis

6. RESULT
• 5102 women in 9 trials (2899 BCT and 2203 Mastectomy)

7. Meta-analysis Results (OS) ->
Mastectomy significant benefit in Overall
Survival

8. Tumor site <2cm: significant difference in OS

9. OS sensitivity analysis : NO significant

10. DFS : NO survival difference

11. DFS : NO favor in tumor size

12. DFS : sensitivity NO favor

13. CONCLUTION
• MRM : STANDART treatment until 1980s, but BCT IMPROVED over past
decades
• This meta-analysis demonstrates : Slight benefit mastectomy compared BCT
for EBC
• BCT associated greater risk locoregional reccurence, Nowadays sistemic
therapy after surgery decreased lower the risk of reccurence.
• This follow-up time studies in 25 years -> is well known reccurence reported
20-30 years after initial Dx/
• Predictive factor for survival outcome after BCT : TUMOR SIZE (ranged 2-

14. THANK YOU