Is Breast Conserving Surgery Efficacious in Breast Cancer Patients with or Germline Mutation?

Background: The optimal surgical therapy for newly diagnosed breast cancer with germline mutations in susceptibility genes is still uncertain for many physicians. In this study, we aimed to determine the efficacy of breast conserving surgery (BCS) in breast cancer patients with or mutation by assessing its outcomes and locoregional recurrence (LR) rates.

Materials And Methods: Seventy-five patients operated with BCS or mastectomy for breast cancer between 2006 and 2017 and had or mutation were included in the study. Effects of the performed breast surgery and clinicopathological characteristics on surgical outcomes, LR rates and survival were analyzed with showing the distribution of and germline mutations.

Results: The median age of the patients was 42 years (20-77). mutations were found in 46 (61.3%) patients and mutations in 29 (38.7%) patients. Compared to carriers, carriers were more likely to have higher tumor grade (84.8% vs 44.8%; = 0.001) and non-luminal subtype tumors (67.4% vs 13.8%; = 0.001). A total of 44 (58.7%) patients underwent unilateral mastectomy and 31 (41.3%) patients underwent BCS. At a median follow-up time of 60 (12-240) months, LR was observed in 6 patients equally divided in both BCS and mastectomy groups. LR rates were slightly higher after BCS versus mastectomy (9.7% and 6.8%, respectively). Additionally, there were no statistically significant differences in disease-free survival (DFS) and disease-specific survival (DSS) rates after 10 years in the BCS group versus the mastectomy group ( = 0.117 and 0.109, respectively), but in fact, the rates were better in the BCS group.

Conclusion: Our findings indicate that BCS may serve as an efficacious alternative to mastectomy for breast cancer patients with or mutation. Additionally, tumor size, lymph node positivity, and TNM stage should be taken into consideration for a better surgical decision-making.