Sharon W W Chan1, Catherine Cheung2, Amy Chan2, Polly S Y Cheung2. 1. Kowloon East Cluster Breast Centre, Department of Surgery, United Christian Hospital, Hong Kong, China. Electronic address: research@hkbcf.org. 2. Hong Kong Breast Cancer Foundation, Hong Kong, China.
Abstract
BACKGROUND: Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancer patients. METHODS: Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I-II breast cancer patients who had surgical treatments were included in this retrospective study. RESULTS: Our multivariate logistic regression shows that people who were younger (age < 40 years: OR, 1.5; 95% CI, 1.1-2.1; p = 0.010), more educated (undergraduate/postgraduate: OR, 2.8; 95% CI, 1.7-4.4; p < 0.0001), never married (OR, 1.5; 95% CI, 1.1-1.9; p = 0.002), had regular mammography screening (OR, 1.5; 95% CI, 1.3-1.8; p < 0.0001), had screen-detected cancers (OR, 1.3; 95% CI, 1.0-1.6; p = 0.031), and who underwent surgery at a private medical service facility (OR, 1.8; 95% CI, 1.6-2.2; p < 0.0001) were more likely to receive BCS. In addition, people who were younger (age < 40 years: OR, 15.9; 95% CI, 6.5-39.2; p < 0.0001), more educated (undergraduate/postgraduate: OR, 26.8; 95% CI, 3.6-201.4; p = 0.001), had regular mammography screening (OR, 1.6; 95% CI, 1.1-2.3; p = 0.008), had screen-detected cancers (OR, 2.1; 95% CI, 1.4-3.3; p = 0.001), and had smaller tumor (≤ 2.0 cm: OR, 0.39; 95% CI, 0.20-0.76; p = 0.005) were more likely to have reconstruction after MTX. CONCLUSION: Chinese patients have lower BCS and breast reconstruction rate. Besides cultural difference, patient-related factors such as age, education, marital status, mammography screening, the use of private medical facilities, and clinical characteristics including smaller tumor size and peripherally located tumor were significant predictors for type of surgical treatments in Chinese women with early breast cancer.
BACKGROUND: Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancerpatients. METHODS: Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I-II breast cancerpatients who had surgical treatments were included in this retrospective study. RESULTS: Our multivariate logistic regression shows that people who were younger (age < 40 years: OR, 1.5; 95% CI, 1.1-2.1; p = 0.010), more educated (undergraduate/postgraduate: OR, 2.8; 95% CI, 1.7-4.4; p < 0.0001), never married (OR, 1.5; 95% CI, 1.1-1.9; p = 0.002), had regular mammography screening (OR, 1.5; 95% CI, 1.3-1.8; p < 0.0001), had screen-detected cancers (OR, 1.3; 95% CI, 1.0-1.6; p = 0.031), and who underwent surgery at a private medical service facility (OR, 1.8; 95% CI, 1.6-2.2; p < 0.0001) were more likely to receive BCS. In addition, people who were younger (age < 40 years: OR, 15.9; 95% CI, 6.5-39.2; p < 0.0001), more educated (undergraduate/postgraduate: OR, 26.8; 95% CI, 3.6-201.4; p = 0.001), had regular mammography screening (OR, 1.6; 95% CI, 1.1-2.3; p = 0.008), had screen-detected cancers (OR, 2.1; 95% CI, 1.4-3.3; p = 0.001), and had smaller tumor (≤ 2.0 cm: OR, 0.39; 95% CI, 0.20-0.76; p = 0.005) were more likely to have reconstruction after MTX. CONCLUSION: Chinese patients have lower BCS and breast reconstruction rate. Besides cultural difference, patient-related factors such as age, education, marital status, mammography screening, the use of private medical facilities, and clinical characteristics including smaller tumor size and peripherally located tumor were significant predictors for type of surgical treatments in Chinese women with early breast cancer.