Literature DB >> 22483323

Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database.

Carlos A Garcia-Etienne1, Mariano Tomatis, Joerg Heil, Kay Friedrichs, Rolf Kreienberg, Andreas Denk, Marion Kiechle, Fatemeh Lorenz-Salehi, Rainer Kimmig, Günter Emons, Mahmoud Danaei, Volker Heyl, Uwe Heindrichs, Christoph J Rageth, Wolfgang Janni, Lorenza Marotti, Marco Rosselli del Turco, Antonio Ponti.   

Abstract

INTRODUCTION: Recent single-institution reports have shown increased mastectomy rates during the last decade. Further studies aiming to determine if these reports could be reflecting a national trend in the United States of America (US) have shown conflicting results. We report these trends from a multi-institutional European database. PATIENTS AND METHODS: Our source of data was the eusomaDB, a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists (EUSOMA). We identified patients with newly diagnosed unilateral early-stage breast cancer (stages 0, I or II) to examine rates and trends in surgical treatment.
RESULTS: A total of 15,369 early-stage breast cancer cases underwent surgery in 13 Breast Units from 2003 to 2010. Breast conservation was successful in 11,263 cases (73.3%). Adjusted trend by year showed a statistically significant decrease in mastectomy rates from 2005 to 2010 (p = 0.003) with a progressive reduction of 4.24% per year. A multivariate model showed a statistically significant association of the following factors with mastectomy: age < 40 or ≥ 70 years, pTis, pT1mi, positive axillary nodes, lobular histology, tumour grade II and III, negative progesterone receptors and multiple lesions.
CONCLUSION: Our study demonstrates that a high proportion of patients with newly diagnosed unilateral early-stage breast cancer from the eusomaDB underwent breast-conserving surgery. It also shows a significant trend of decreasing mastectomy rates from 2005 to 2010. Moreover, our study suggests mastectomy rates in the population from the eusomaDB are lower than those reported in the US.
Copyright © 2012 Elsevier Ltd. All rights reserved.

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Year:  2012        PMID: 22483323     DOI: 10.1016/j.ejca.2012.03.008

Source DB:  PubMed          Journal:  Eur J Cancer        ISSN: 0959-8049            Impact factor:   9.162


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