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Title of Journal: Breast Cancer Res Treat

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Abbravation: Breast Cancer Research and Treatment

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Springer US

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DOI

10.1016/0270-9139(95)94584-9

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1573-7217

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Trends in the use of mastectomy in women with smal

Authors: Ines VazLuis Melissa E Hughes Angel Cronin Hope S Rugo Stephen B Edge Beverly Moy Richard L Theriault Michael J Hassett Eric P Winer Nancy U Lin
Publish Date: 2016/02/11
Volume: 155, Issue: 3, Pages: 569-578
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Abstract

Breastconserving surgery BCS provides equivalent survival outcomes to unilateral mastectomy There is no survival advantage to bilateral mastectomy in average risk breast cancer Among a cohort of breast cancer patients expected to be candidates for BCS we examined choice of surgery and factors associated with it A prospective cohort study of unilateral clinical Stage I breast cancer patients treated at National Comprehensive Cancer Network centers from 2000 to 2009 was performed The proportion of patients who initially underwent mastectomy versus BCS and time to definitive surgery and chemotherapy were examined Of 10249 patients 23  underwent mastectomy as an initial surgery No decline in the use of mastectomy as initial surgery was found There was significant institutional variation with rates of initial mastectomy ranging from 14 to 30  adjusted odds ratio 042–138 Tumor characteristics were associated with surgical option but with small absolute differences Of those who received initial mastectomy 22  had bilateral mastectomy with an increase over time 200013  vs 200930  and substantial institutional variation 11–34  Women treated with initial mastectomy had longer median times from diagnosis to complete definitive surgery 6 vs 4 weeks and to start of adjuvant chemotherapy 12 vs 11 weeks Among Stage I breast cancer the overall use of mastectomy did not change significantly over 10 years however an increasing proportion of women with unilateral cancer had bilateral mastectomy and there was wide variation in type of surgery by institution Further studies to assess reasons for the observed wide variation are warranted

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