Are Mastectomy Rates Really Increasing in the United States?

Habermann, Elizabeth B.; Abbott, Andrea M.; Parsons, Helen; Virnig, Beth A; Al‐Refaie, Waddah B.; Tuttle, Todd M.

doi:10.1200/jco.2009.27.6774

Cited by 200 publications

(171 citation statements)

References 24 publications

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“…A similar rate of 37% was reported from USA SEER data for [2000][2001][2002][2003][2004][2005][2006], although this applied to combined ductal carcinoma in situ and AJCC TNM stages I to III invasive cancers, whereas our data were for invasive cancers classified using the NHMRC definition of early invasive breast cancer (i.e., tumours <50mm in size and without fixed nodes or distant metastases) (National Breast Cancer Centre, 2001;Cuncins-Hearn et al, 2006;Habermann et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Statement and reviews of evidence from randomized trials (Abrams et al, 1995;Fisher et al, 1995), mastectomy rates declined markedly in the U.S. (Lazovich et al, 1991;Lazovich et al, 1997;Habermann et al, 2010), Canada, (Gaudette et al, 2004) European countries, (Zorzi et al, 2006), although with a more recent upturn suggested in some North American localities (Tuttle et al, 2007;Katipamula et al, 2009;Dragun et al, 2012a;2012b). Australian data also showed a trend away from mastectomy towards breast conserving surgery both nationally and in a number of jurisdictions (Hill et al, 1990;1994;Byrne et al, 1993;South Australian Cancer Registry, 2000;Cuncins-Hearn et al, 2006;Kricker, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Australian data also showed a trend away from mastectomy towards breast conserving surgery both nationally and in a number of jurisdictions (Hill et al, 1990;1994;Byrne et al, 1993;South Australian Cancer Registry, 2000;Cuncins-Hearn et al, 2006;Kricker, 2011). Today only about 40% of early breast cancers are treated by mastectomy in the U.S. and Australia (Cuncins-Hearn et al, 2006;Habermann et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Roder¹,

Zorbas²,

Kollias³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (≤10) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Conclusions: Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Roder¹,

Zorbas²,

Kollias³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…The justification of this increase was related to the use of MRI of the breast 23 and greater liberality in conducting prophylactic operations 25 . Studies using population-based cancer registries showed reduction of mastectomies in the United States 25 , Norway 26 and Spain 27 , though. During the study period our patients did not have access to breast MRI; prophylactic mastectomy, although described in our protocol, has hardly been used.…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

Variação temporal do tratamento cirúrgico do câncer de mama em um hospital universitário na região Centro-Oeste do Brasil

Freitas‐Junior

Siqueira²,

Carrijo³

et al. 2013

Rev. Col. Bras. Cir.

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OBJETIVO: avaliar os tipos de tratamentos cirúrgicos para o câncer de mama executados pelo Programa de Mastologia do Hospital das Clinicas da Universidade Federal de Goiás (HC-UFG). MÉTODOS: estudo de coorte transversal no histórico de operações mamárias realizadas no HC-UFG, no período de janeiro de 2002 a dezembro de 2009. Foram avaliados através do boletim cirúrgico: o tempo e o porte cirúrgicos; o cirurgião responsável, o tipo de operação; o diagnóstico, e o tipo de anestesia. Através dos prontuários foram analisados: o laudo anatomopatológico do tumor, o comprometimento linfonodal, o tamanho do tumor primário, o estadiamento e a realização de terapias neoadjuvantes. Foram excluídas as operações realizadas para a retirada de tumores benignos da mama. A variação temporal foi analisada pela regressão de Poisson, considerando a mudança percentual anual (MPA). RESULTADOS: foram realizadas 403 operações de câncer de mama no período estudado, com uma média de 50,38 operações por ano. O tipo histológico mais frequente foi o carcinoma ductal invasor (72,6%). A média de idade das pacientes foi 52 anos, e 29% encontravam-se com doença nos estádios III e IV. A tendência temporal mostrou que houve aumento significativo do tamanho do tumor (p<0,01), dos estadios clínicos III e IV (p=0,01), e de quimioterapia neoadjuvante (p=0,02). Observou-se aumento de mastectomias (MPA=9 casos/ano, p=0,04). Não houve aumento dos casos de tratamentos com conservação mamária, nem de reconstruções imediatas. CONCLUSÃO: nos últimos anos, no HC-UFG, tem ocorrido aumento do número de mastectomias em decorrência do aumento de casos de câncer de mama locorregional avançado.

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“…These days standard practice is breast conserving surgery followed by adjuvant radiotherapy for early presentation [1] and mastectomy followed by adjuvant radiotherapy of the chest wall with or without chemotherapy in advanced cases [2]. Many studies [3,4] have shown that adjuvant radiotherapy to the chest wall improves local control and also survival in node positive and advanced node negative breast cancer patients after mastectomy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Incidental Radiation Dose to Axilla and Internal Mammary Nodal Area by Conventional, 3DCRT, and IMRT Technique in Carcinoma of Breast

Hb¹,

Thimmaiah²,

Ia³

et al. 2017

J Nucl Med Radiat Ther

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Purpose: To quantify the incidental radiation dose delivered to axilla and internal mammary nodal (IMN) area by Conventional Tangential Radiation Therapy (CRT), 3 Dimensional Conformal Radiation Therapy (3DCRT) and Intensity Modulated Radiation Therapy (IMRT). Methods and Materials:We prospectively evaluated incidental radiation to axilla in twenty cases of breast cancer treated with adjuvant radiation therapy. Three plans were generated for each case, comprising CRT, 3DCRT and IMRT tangents. Radiation doses to axillary levels I, II, III, and IMN areas were evaluated for mean dose, V95, V80 and V50. Comparisons were made using ANOVA. Results:The mean volume and range of the axillary level I, II, III, and IMN were 61.1 cc and 142-57 cc; 42.6 cc and 61-21cc; 19.5 cc and 34-15 cc; 13.2 cc and 21-9 cc respectively. The mean dose to axilla by 3 techniques (by IMRT, 3DCRT and CRT) to Level I, II, III, and IMN were 75%, 53%, 38%, and 61% vs. 81%, 64%, 44% and 77% vs. 92%, 86%, 53% and 92% respectively (p<0.05). The V95 values (volume receiving 95% of dose) for the three techniques were 43%, 39%, 17% and 49% by IMRT: 40%, 45%, 21% and 59% by 3DCRT; 72%, 61%, 24% and 65% by CRT (IMRT vs. 3DCRT for level II axilla, IMRT vs. CRT and 3DCRT vs. CRT-p<0.05) The V80 were 49%, 53%, 29%, and 57% by IMRT; 55%, 47%, 34% and 68% by 3DCRT; 85%, 77%, 44% and 69% by CT (IMRT vs. 3DCRT for level III axilla and IMN, IMRT vs. CRT and 3DCRT vs. CRT -p<0.05). The V50 values were 75%, 65%, 41% and 66% by IMRT; 82%, 53%, 57% and 84% by 3DCRT; 94%, 89%, 42% and 90% by CRT (IMRT vs. 3DCRT, IMRT vs. CRT, and 3DCRT vs. CRP-p<0.05). Conclusion:Axillary and internal mammary nodal areas receive substantial amount of incidental radiation doses with all the three techniques; however, conformal techniques (IMRT, 3DCRT) deliver significantly lesser incidental radiation to lower axilla than CRT technique.

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Are Mastectomy Rates Really Increasing in the United States?

Cited by 200 publications

References 24 publications

Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

Variação temporal do tratamento cirúrgico do câncer de mama em um hospital universitário na região Centro-Oeste do Brasil

Comparison of Incidental Radiation Dose to Axilla and Internal Mammary Nodal Area by Conventional, 3DCRT, and IMRT Technique in Carcinoma of Breast

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