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Annals of Oncology Advance Access originally published online on January 10, 2008
Annals of Oncology 2008 19(6):1039-1044; doi:10.1093/annonc/mdm573
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

reviews

Breast conservation therapy for stage I or stage II breast cancer: a meta-analysis of randomized controlled trials

S. H. Yang1,3, K. H. Yang1,*, Y. P. Li2, Y. C. Zhang3, X. D. He3, A. L. Song3, J. H. Tian1, L. Jiang1, Z. G. Bai1, L. F. He1, Y. L. Liu1 and B. Ma1

1 Evidence Based Medicine Center of Lanzhou University, Lanzhou City, Gansu Province
2 Chinese Cochrane Center, Chengdu, Sichuan
3 Department of General Surgery, Lanzhou University Second Hospital, Lanzhou City, Gansu Province, China

* Correspondence to: Prof. K. H. Yang, Evidence Based Medicine Center of Lanzhou University, Donggang West Road No. 199, Chengguan District, Lanzhou City 730030, Gansu Province, China. Tel: +86-931-8915076; Fax: +86-931-8915076; E-mail: kehuyangebm2006{at}126.com

Background: We carried out a meta-analysis to determine the effectiveness of breast conservation therapy (BCT) or mastectomy (MT) for stage I or stage II breast cancer.

Methods: A fully recursive literature search was conducted in the Cochrane Controlled Trials Register Databases, Medline, EMBASE and Chinese Biomedical Literature Database in any language. Randomized controlled trials (RCTs) were considered for inclusion. Analyses were carried out using RevMan software.

Results: In all, 18 RCTs including a total of 9388 patients were included. The meta-analysis showed that the overall survival in 3, 5, 10, 15 and 20 years and the locoregional recurrence rate in 3, 5, 15 and 20 years were not statistically significantly different between group BCT and group MT, but 10-year locoregional recurrence rate increased in group BCT. The sensitivity analysis indicated that both overall survival and locoregional recurrence rate were not statistically significant difference between group BCT and group MT. In the subgroup analysis, there was no significant difference in OS and locoregional recurrence rate between group BCT and group MT, but 20-year locoregional recurrence rate was statistically significantly higher in group BCT than group MT for women with tumors 2 cm or smaller.

Conclusion: BCT was better choice than MT for women with stage I or stage II breast cancer.

Key words: breast conservation therapy, breast neoplasms, mastectomy, meta-analysis, randomized controlled trials

Received for publication August 23, 2007. Revision received November 18, 2007. Accepted for publication November 27, 2007.


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