SynthesisBreast (Edinburgh, Scotland)2021
Combined breast conservation therapy versus mastectomy for BRCA mutation carriers - A systematic review and meta-analysis.
Synthesis in Breast (Edinburgh, Scotland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with early breast cancer.ESMO open · 2024Guideline
- Sentinel lymph node biopsy in patients with ductal carcinoma in situ: systematic review and meta-analysis.BJS open · 2022Pooled it
- The increasing role of breast-conserving treatment in patients with BRCA-related breast cancer: an appraisal of recent literature.Frontiers in oncology · 2026Review
- Article
- Article
- Breast-Conserving Surgery inLife (Basel, Switzerland) · 2025Review
- Great Debate: Does Breast-Conserving Surgery with Radiotherapy Offer Better Survival than Mastectomy in Early-Stage Breast Cancer?Annals of surgical oncology · 2025Article
- The impact of loco-regional treatment on ipsilateral breast cancer recurrence and outcomes in carriers of BRCA1/2 pathogenic variants.Breast cancer research and treatment · 2025Article
- Translational breast cancer research : a journal focusing on translational research in breast cancer · 2025Review
- Role of Breast Cancer Risk Estimation Models to Identify Women Eligible for Genetic Testing and Risk-Reducing Surgery.Biomedicines · 2024Review
- ER-positive and BRCA2-mutated breast cancer: a literature review.European journal of medical research · 2024Review
- HR-positive/HER2-negative breast cancer arising in patients with or withoutTherapeutic advances in medical oncology · 2024Article
- Czech Women's Point of Views on Immediate Breast Reconstruction after Mastectomy due to BRCA Gene Mutation or Breast Cancer.Healthcare (Basel, Switzerland) · 2023Article
- Molecular profiling in contemporary breast cancer management.The British journal of surgery · 2023Article
- EBCC-13 manifesto: Balancing pros and cons for contralateral prophylactic mastectomy.European journal of cancer (Oxford, England : 1990) · 2023Review
- The underused potential of breast conserving therapy after neoadjuvant system treatment - Causes and solutions.Breast (Edinburgh, Scotland) · 2023Review
- Surgical options for patients with early-stage breast cancer and pathogenic germline variants: an oncologist perspectives.Frontiers in oncology · 2023Review
- Is Breast Conserving Surgery Efficacious in Breast Cancer Patients withBreast cancer (Dove Medical Press) · 2023Article
- Effectiveness of Secondary Risk-Reducing Strategies in Patients With Unilateral Breast Cancer With Pathogenic Variants of BRCA1 and BRCA2 Subjected to Breast-Conserving Surgery: Evidence-Based Simulation Study.JMIR formative research · 2022Article
- Breast-Conserving Surgery or Mastectomy?: Impact on Survival.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe non-inferiority of combined breast conservation surgery (BCS) and radiotherapy (breast conservation therapy or BCT) compared to mastectomy in sporadic breast cancer cases is well recognised. Uncertainty remains regarding optimal surgical practice in BRCA mutation carriers.
aimsTo evaluate the oncological safety of combined BCT versus mastectomy in BRCA mutation carriers following breast cancer diagnosis.
methodsA systematic review was performed as per PRISMA and MOOSE guidelines. Observational studies comparing BCS and mastectomy in BRCA carriers were identified. Dichotomous variables were pooled as odds ratios (OR) using the Mantel-Haenszel method. Log hazard ratios (lnHR) for locoregional recurrence (LRR), contralateral breast cancer, disease-free and overall survival and their standard errors were calculated from Kaplan-Meier or cox-regression analyses and pooled using the inverse variance method.
resultsTwenty three studies of 3807 patients met inclusion criteria; 2200 (57.7%) were BRCA1 and 1212 (31.8%) were BRCA2 carriers. Median age at diagnosis was 41 years with 96 months follow up. BCS was performed on 2157 (56.7%) while 1408 (41.5%) underwent mastectomy. An increased risk of LRR was observed in patients treated with BCS (HR:4.54, 95% Confidence Interval: 2.77-7.42, P < 0.001, heterogeneity (I
conclusionsSurvival outcomes following combined BCT is comparable to mastectomy in BRCA carriers. However, the risk of LRR is increased. Patient counselling should be tailored to incorporate these findings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.