Comparing Local Recurrence and Distant Metastasis Between Breast-Conserving Therapy with Radiotherapy and Total Mastectomy in Candidates for PET/CT Assessment

Background: This study aimed to compare the recurrence rate of breast cancerbetween women treated with breast-conserving therapy (BCT) with/withoutradiotherapy and those treated with total mastectomy using 18F-fluorodeoxyglucosepositron emission tomography/computed tomography18 (F-FDG PET/CT).Methods: The current study retrospectively included 588 patients sufferingfrom breast cancer who had been referred to the PET/CT department of Masih-e-Daneshvari Hospital in Tehran between April 2013 and September 2019. Data ofall female patients with breast cancer were extracted from the recorded hospitalfiles. Based on the treatment plan, patients were divided into two groups: BCTwith/without radiotherapy (n=168) and total mastectomy (n=420). Local,locoregional, and distant metabolically active lesions were determined in18 F-FDGPET/CT and compared between groups.Results: BCT and total mastectomy were comparable regarding local (28.5% vs.25.7%, P=0.200) and locoregional (21.4% vs. 22.8%, P=0.712) recurrence, whiledistant recurrence was significantly higher with total mastectomy (88.5% vs. 64.2%,P<0.001). Also, lymph node invasion (42.9% vs. 60%m P<0.001) and positivePET/CT (78.5% vs. 88.5%, P=0.002) were significantly higher with total mastectomy.According to multivariate analysis, age, clinical stage, and positive margin areindependently correlated with the rate of distant metastasis.Conclusion: According to our analysis, breast-conserving therapy could be asuitable choice of surgery in selected patients since local and locoregionalrecurrence rate did not significantly differ between patients who underwent breastconservingsurgery compared to those who were treated with total mastectomy.Higher rate of distant metastasis in patients with total mastectomy seems to beinfluenced by many confounding variables such as age, higher stage of diagnosisand positive margin rather than type of surgery.

Comparing Local Recurrence and Distant Metastasis Between Breast-Conserving Therapy with Radiotherapy and Total Mastectomy in Candidates for PET/CT Assessment Keywords:

Breast cancer , recurrence , breast-conserving therapy , total mastectomy , 18 F-FDG PET/CT