Oncologic Outcomes of Central Quadrantectomy Versus Total Mastectomy in Early-Stage Breast Cancer

초록

Purpose: Although total mastectomy (TM) is the standard treatment for breast cancer involving the nipple-areolar complex (NAC) or the central breast, recent advances suggest that central quadrantectomy (CQ) might offer comparable outcomes. This study compared the longterm oncologic outcomes of CQ and TM in patients with early-stage breast cancer. Methods: We conducted a retrospective study of patients with early-stage breast cancer who were treated between 2010 and 2024. A total of 340 patients were included: 23 underwent CQ and 317 underwent TM (conventional, skin-sparing, or nipple-sparing). Statistical analyses included Chi-square test, Cox regression analysis, and Kaplan-Meier analysis for survival and locoregional recurrence (LRR). To control for baseline differences, multivariable Cox regression analysis was performed to identify independent predictors of oncologic outcomes. Results: The LRR rate was 8.7% and 5.4% in the CQ and TM group, respectively, with no statistically significant difference (p=0.502). In the multivariable analysis adjusted for confounding factors, the surgical method (CQ vs. TM) was not an independent risk factor for LRR or overall survival (OS). This lack of significant difference was consistently observed in the subgroup analysis of patients with invasive breast cancer (p=0.169). In the TM group, NAC preservation was not associated with an increased overall risk of LRR (p=0.496), although NAC-specific recurrence was anatomically restricted to the preservation group. The OS rates were comparable between the two groups (p=0.433). Conclusion: CQ appears to demonstrate oncologic outcomes comparable to those of TM in carefully selected patients with early-stage breast cancer. This may be considered a feasible surgical option when performed with appropriate patient selection and adjuvant therapy.

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