Modified Radical Mastectomy vs Oncoplastic Breast-Conserving Surgery: Quest for Recurrence Risk Model

By: Amanda E. Ruffino, BA
Posted: Tuesday, January 16, 2024

Yuan et al, of the First People’s Hospital of Changde City, Hunan, China, and colleagues aimed to evaluate the clinical efficacy of modified radical mastectomy vs oncoplastic breast-conserving surgery for early-stage breast cancer treatment. Published in the American Journal of Cancer Research, this retrospective analysis revealed that despite longer operation times for oncoplastic breast-conserving surgery, patients experienced significantly less intraoperative bleeding, postoperative drainage, and hospitalization compared with the modified radical mastectomy group. Additionally, patients undergoing oncoplastic breast-conserving surgery exhibited higher subjective satisfaction, better quality-of-life scores, and comparable objective outcomes.

Postoperative complications and recurrence rates did not significantly differ between the two groups. However, multivariate Cox regression analysis identified lymph node metastasis and molecular type as independent prognostic factors for disease-free survival. A risk model based on these variables predicted recurrence effectively, according to the investigators, with an AUC of 0.852. Lower risk scores correlated with significantly higher disease-free survival rates.

The investigators focused on the medical data of 149 patients with early-stage breast cancer treated at their institution from between January 2018 and January 2022. A total of 104 patients were treated with modified radical mastectomy (the control group), and 45 patients were treated with oncoplastic breast-conserving surgery (the observation group). The groups were comparable in terms of age, body mass index, tumor diameter, tumor stage, lymph node metastasis, and molecular type, the authors noted.

The investigators’ key finding suggests that compared with modified radical mastectomy, oncoplastic breast-conserving surgery may reduce the surgical incision and enhance patient satisfaction, without increasing complication or recurrence risks. The risk model, developed through Cox regression, has potential clinical value in predicting breast cancer recurrence and facilitating personalized patient management and treatment planning. It may contribute to the ongoing quest for effective early-stage breast cancer treatments, emphasizing the importance of tailoring interventions based on individual risk factors identified through a risk model.

Disclosure: The study authors reported no conflicts of interest.

American Journal of Cancer Research

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