Are Mastectomies on the Rise? A 13-Year Trend Analysis of the Selection of Mastectomy Versus Breast Conservation Therapy in 5865 Patients

Abstract

The perception of an increasing choice toward mastectomy has been confirmed at this institution. Possible reasons are younger population with higher lifetime risk, higher stage disease, and more biologically aggressive or diffuse tumors. Patient preference, fear of genetic or recurrence risk, and "intangible" factors seem to shift decisions toward mastectomy.

Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context

“…The majority of the patients in the study cohort were Chinese, and expected to have similar physical attributes in terms of breast tissue volume as Chinese women elsewhere. Still, BCT rates in the study cohort are higher than in other Chinese-dominant countries (Chuwa et al, 2009;Yau et al, 2009;Yip et al, 2009;Chang et al, 2011;Wang et al, 2011) and are similar to, if not also higher than, those reported in Western countries (Lee et al, 2009;McGuire et al, 2009;Garcia-Etienne et al, 2012;Agarwal et al, 2014). Hence, the issue of smaller breast tissue volume and its impact on BCT rates needs further investigation.…”

“…This is different from data in a western community where there was no age trend. In fact, 23.4% of women aged 50 years or younger chose a mastectomy, while 17.3% of women older than 50 years chose a mastectomy over BCT (McGuire et al, 2009).…”

“…For best outcomes for patients with breast cancer, steps should therefore be taken to modify factors associated with higher mastectomy rates (Roder et al, 2013). It is encouraging that active measures are being made in certain countries to increase BCT rates (Omranipour et al, 2014) despite the current trend of rising trend of mastectomy in others (McGuire et al, 2009).…”

“…In the light of this new data, one could consider BCT as the preferred modality of surgical treatment for breast cancer when eligibility criteria are fulfilled. In Western countries, BCT rates are often reported to be in excess of 60% (Table 1) (Lee et al, 2009;McGuire et al, 2009;Garcia-Etienne et al, 2012;Agarwal et al, 2014). This is in contrast to…”

Technique and outcome of post-mastectomy adjuvant chest wall radiotherapy—the role of tissue-equivalent bolus in reducing risk of local recurrence

“…3 This trend is not reflected in the USA, where studies have shown mastectomy rates remaining between 30 and 40%, with a greater percentage of patients choosing to undergo mastectomy in spite of being suitable for breast-conserving surgery. 4 Common indications for mastectomy include patients with multifocal invasive or in situ cancer, those in whom breast conservation would have a suboptimal cosmetic outcome or patient preference for mastectomy. 5 Radiotherapy is offered to patients with breast cancer with risk factors for chest wall recurrence to reduce the risk of locoregional recurrence after mastectomy.…”