Zie ook literatuurlijst niet-toxische middelen en behandelingen specifiek bij borstkanker, samengesteld door arts-bioloog drs. Engelbert Valstar

30 juni 2020: Bron: Cancer Medicine online

Een borstbesparende operatie (lumpectomie) bij borstkankerpatiënten met een zogeheten mucineuze vorm van borstkanker blijkt een lager risico op overlijden door welke oorzaak dan ook te geven in vergelijking met een volledige borstamputatie (mastectomy) (HR, 0,786). Vooral bij patiënten met T1–2-stadiëring en tussen de 50 en 79 jaar oud.

Deze toch wel verrassende resultaten komen uit de gegevens van een SEER-populatieonderzoek (SEER = Surveillance, Epidemiology and End Results (SEER) van het National Cancer Institute (NCI)),waarbij de gegevens van 8330 patiënten werden geanalyseerd.
Deze studie evalueerde lange termijn resultaten (mediane follow-up, 77 maanden) tussen borstamputatie (15% van cohort) en borstsparende operatie (85% van cohort) bij totaal 8330 patiënten met slijmachtig borstcarcinoom (mucineus carcinoom) zoals geregistreerd in de SEER-database.

Uit deze bron: Mucineuze carcinoom is een invasieve vorm van kanker die begint in een inwendig orgaan dat mucine produceert, het primaire bestanddeel van slijm. De abnormale cellen in dit type tumor drijven in het mucine en het mucine wordt een deel van de tumor. Deze zeldzame vorm van kanker kan voorkomen in elk deel van het lichaam dat mucine produceert. Het wordt vaker aangetroffen in de borst, meestal samen met andere soorten kankercellen. Ongeveer 5 procent van alle invasieve vormen van borstkanker heeft mucineus carcinoom.

Mucineus carcinoom wordt ook colloïde carcinoom genoemd. Het is een subtype van invasief ductaal carcinoom dat een vaker voorkomende vorm van borstkanker is.

Deze vrij zeldzame vorm van kanker komt dus het meeste voor bij borstkanker, maar soms ook wel in de darmen of longen bv. Meestal is borstkanker een mengvorm van verschillende typeringen van tumoren en niet een pure vorm van mucineuze oorsprong.

Conclusie:

Uit de studie blijkt dat een borstsparende therapie gepaard ging met een lager risico op overlijden door welke oorzaak dan ook (HR, 0,786), vooral bij patiënten met T1–2-stadiëring en tussen de 50 en 79 jaar oud. Deze bevindingen zijn in tegenstelling tot resultaten eerder gerapporteerd in kleinere studies met kortere follow-upperioden. Tussen de groepen werd geen verschil in borstkankerspecifieke overleving waargenomen.

Het volledige studierapport: Breast‐conserving therapy shows better prognosis in mucinous breast carcinoma compared with mastectomy: A SEER population‐based study is volledig en gratis in te zien.

Hier het abstract van deze studie:

Breast‐conserving therapy shows better prognosis in mucinous breast carcinoma compared with mastectomy: A SEER population‐based study

Ping Yu

Na Li

First published:08 June 2020

https://doi.org/10.1002/cam4.3202

Ping Yu, Peng Liu and Yutian Zou are contributed equally to this work.

Funding information:

This work was sponsored by funds from the National Natural Science Foundation of China (81672598 and 81472575), the National Natural Science Foundation of Guangdong (2018A0303130285, Feng Ye), and Science and Technology Planning Projects of Guangdong (2017A020215197, Feng Ye).

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Abstract

Background

Mucinous breast carcinoma (MBC) is a relatively rare pathological type of breast cancer. Compared with mastectomy in MBC, the effect and safety of breast‐conserving therapy (BCT) remains unclear. Therefore, we investigated the long‐term prognosis of BCT and mastectomy in T1‐2 stage mucinous breast carcinoma via the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Totally, 8830 patients who were diagnosed of mucinous breast carcinoma between 2004 and 2014 from SEER database were reviewed retrospectively. Cox proportional hazards model and Kaplan‐Meier method were performed for evaluating the relationship between surgical method and prognosis.

Results

One thousand three hundred and twenty (14.9%) patients underwent mastectomy and 7510 (85.1%) underwent BCT. The median follow‐up time was 77 months. There were more non‐Hispanic white, married, and younger (<65 years) patients, as well as lower stage of tumor sizes, lymph nodes and more favorable histologic grade, ER positive, and PR positive in BCT group (P < .05). Patients in BCT group had relatively better overall survival (OS) than those in mastectomy group. The risk of death from any cause in BCT group was lower than that in mastectomy group significantly (HR = 0.786, 95% CI: 0.703‐0.879, P < .001), while no difference significantly was observed in breast cancer‐specific survival (BCSS) between BCT and mastectomy groups. In stratified analysis according to T stage, BCT group had better OS than mastectomy group for patients of T1 stage (HR = 0.679, 95% CI: 0.589‐0.781, P < .001) or T2 stage (HR = 0.769, 95% CI: 0.646‐0.915, P = .003). In stratified analysis according to the different ages, BCT showed OS benefit in patients at the age of 50‐64 years (HR = 0.587, 95% CI: 0.408‐0.846, P = .004) and the age of 65‐79 years (HR = 0.636, 95% CI: 0.535‐0.758, P = .001). For patients younger than 50 years or not younger than 80 years, there was no difference significantly observed in OS between BCT and mastectomy groups (P > .05).While for patients who received BCT, the use of radiotherapy showed OS benefit.

Conclusions

This large population‐based study indicated patients who received BCT had better prognosis than those received mastectomy in T1‐2 stage MBC, especially in patients at the age of 50‐79 years. The use of radiotherapy showed OS benefit in patients receiving BCT. Breast‐conserving therapy might be preferred over mastectomy especially in locoregional treatment of T1‐2 stage MBC.

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