Factors which affect the use of lumpectomy and mastectomy in an underinsured, safety net hospital population

Klemens, Anne E.; Olsen-Deeter, Lyndsay; Hsu, Chiu Hsieh; Bouton, Marcia E.; Djenic, Brano; Winton, Lisa M.; Komenaka, Ian K.

doi:10.1016/j.amjsurg.2014.07.013

Cited by 6 publications

(5 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding factors affecting the choice of either type of surgery (mastectomy or BCS), most of our findings were consistent with the existing literature. Multifocality, multicentricity [ 30 ], larger tumor size [ 17 , 28 ], and more advanced lymph node status [ 30 ] and stage [ 17 , 29 ] are all linked to higher rates of mastectomy. However, the tumor's pathological type and grade were not significantly correlated with either surgery in our study, which contradicts the previously proposed correlation [ 28 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…NACT is a known factor that decreases the rate of mastectomy and increases the rate of BCS by downstaging the tumor [ 17 ]. However, we found in our study that it was a predictor of mastectomy and can be explained by different causes, such as lack of excellent response, lack of patient compliance with the chemotherapy, multicentricity of a tumor, or it may be due to other factors not studied, such as patient or surgeon preference.…”

Section: Discussionmentioning

confidence: 99%

“…An additional study in 2012 demonstrated the relation between mastectomy and age ≥70 years, living in a rural area, hormone receptor-negative tumor, axillary lymphadenectomy and lobular carcinoma, in addition to the factors in the previous studies [ 15 ]. Receiving chemotherapy preoperatively and the type of surgeon (either breast surgeon and neoplastic breast surgeons or general surgeon) were important factors that led to choosing BCS [ 17 ]. As a part of patients’ preference, having a discussion with the surgeon about breast reconstruction increases the likelihood of the patients choosing mastectomy although reconstruction is mostly not discussed [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trends of mastectomy and breast-conserving surgery and related factors in female breast cancer patients treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2009–2017: A retrospective cohort study

Al-Gaithy

Yaghmoor

Koumu

et al. 2019

Annals of Medicine and Surgery

View full text Add to dashboard Cite

Background Breast cancer is the most common cancer in women and accounts for 14.7% of cancer-related deaths among females worldwide. Its core management includes surgical removal of the tumor either by breast-conserving surgery (BCS) or mastectomy. Choosing between these two procedures may be influenced by factors that are not studied in our region. We aimed to determine the prevalence of BCS and mastectomy and the factors that may influence the choice of procedure. Methods This retrospective study was carried out by reviewing the records of female breast cancer patients who underwent BCS or mastectomy at between 2009 to June 2017, excluding those with metastasis or recurrence. Frequencies and multivariate tests were used for detecting correlations between procedures and demographic, clinicopathological, and radiological factors. Results Of 335 patients (mean age 52.75 ± 12.2 years), 62.4% had mastectomy and 37.6% had BCS. Modified radical mastectomy accounted for 70.8% of mastectomies. Multivariate analysis showed non-Saudi nationality (P = 0.002), multifocal (P = 0.0001) and multicentric tumors (P = 0.0001), large tumor size (P = 0.0001), tumor stages IIIA (P = 0.005) and IIIB (P = 0.014), positive HER2 (0.009), and triple-negative receptor status (P = 0.010) significantly correlated with mastectomy. Conclusion Mastectomy has a much higher prevalence than BCS in our study mainly due to advanced tumor stage at the time of diagnosis. This emphasizes the urgent need for early detection of breast cancer to move towards BCS, with education and increasing awareness of breast cancer and the surgical options, especially that it is more common in a significantly younger population in our area.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends of mastectomy and breast-conserving surgery and related factors in female breast cancer patients treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2009–2017: A retrospective cohort study

Al-Gaithy

Yaghmoor

Koumu

et al. 2019

Annals of Medicine and Surgery

View full text Add to dashboard Cite

show abstract

“…For example, patients with low BMI are more likely to choose modified radical mastectomy [32], while younger patients are more likely to choose breast-conserving surgery and breast reconstruction surgery [33]. Pathological staging was related to MAST, while preoperative chemotherapy was related to BCT [34]. After analyzing the cause, preoperative chemotherapy significantly increased the possibility of breast preservation [35] .…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China

Zhang

Luo

et al. 2021

BMC Cancer

View full text Add to dashboard Cite

Background Both breast-conserving surgery and breast reconstruction surgery are less popular in China, although they can improve patients’ quality of life. The main reason comes from the economy. There is currently no economic evaluation of different surgical treatment options for early breast cancer. Our study aims to assess the economic impact and long-term cost-effectiveness of different surgical treatments for early breast cancer. The surgical approaches are including mastectomy (MAST), breast-conserving therapy (BCT), and mastectomy with reconstruction (MAST+RECON). Methods Based on demographic data, disease-related information and other treatments, we applied propensity score matching (PSM) to perform 1: 1 matching among patients who underwent these three types of surgery in the tertiary academic medical center from 2011 to 2017 to obtain a balanced sample of covariates between groups. A Markov model was established. Clinical data and cost data were obtained from the medical records. Health utility values were derived from clinical investigations. Strategies were compared using an incremental cost-effectiveness ratio (ICER). Results After PSM, there were 205 cases in each group. In the matched data set, the distribution of covariates was fully balanced. The total cost of MAST, MAST+RECON and BCT was $37,392.84, $70,556.03 and $82,330.97, respectively. The quality-adjusted life year (QALYs) were 17.11, 18.40 and 20.20, respectively. Compared with MAST, MAST+RECON and BCT have an ICER of $25,707.90/QALY and $14,543.08/QALY, respectively. The ICER of BCT vs. MAST was less than the threshold of $27,931.04. The reliability and stability of the results were confirmed by Monte Carlo simulation and sensitivity analysis. Conclusions We believe that in the context of the limited resources in China, after comparing the three surgical approaches, BCT is the more cost-effective and preferred solution.

show abstract

“…The use of chemotherapy preoperatively and the surgical qualification of surgeon (breast surgeon, oncologic surgeon or general surgeon) are suggested to be factors that lead to a preference of BCS by another study. 4 In this study, we explore initial, and final patient preferences in regard to BCS and mastectomy in early breast cancer. Their work up was done, and the cases discussed one multidisciplinary meetings.…”

Section: Introductionmentioning

confidence: 99%

Overview of Patient Preferences in the Surgical Management Plan of Early Breast Cancers

Khan

Mushtaq

Naqvi

et al. 2021

PAFMJ

View full text Add to dashboard Cite

Objective: To determine patient preferences in the surgical options of early breast cancers and surgeon’s role in the decisionmaking. Study Design: cross-sectional study. Place and Duration of Study: Breast Surgery Department, Combined Military Hospital Rawalpindi Pakistan, from Nov 2020 to May 2021. Methodology: Patients having early carcinoma breast were studied, i.e., clinical stage 1 or 2, and their surgical preference was recorded. The cases were discussed in multidisciplinary meetings, and a discussion session with patient conducted and then final decision taken from the patient was recorded again, and the results compared. Results: A total of 28 patients were included in this study and their surgical preferences recorded. Of these patients 22 (78.5%) agreed to breast conservation initially, whereas one of the patients wanted mastectomy. Five (17.8%) patients were undecided between the two. After multidisciplinary team recommendation and discussion with surgeon, only one patient opted for mastectomy (3.6%). Conclusion: Patients with early breast cancer when offered a surgical decision between breast conservation and mastectomy mostly opt for breast conservation; those who select mastectomy do so because of the fear of recurrence.

show abstract

Factors which affect the use of lumpectomy and mastectomy in an underinsured, safety net hospital population

Cited by 6 publications

References 37 publications

Trends of mastectomy and breast-conserving surgery and related factors in female breast cancer patients treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2009–2017: A retrospective cohort study

Trends of mastectomy and breast-conserving surgery and related factors in female breast cancer patients treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2009–2017: A retrospective cohort study

Cost-effectiveness of different surgical treatment approaches for early breast cancer: a retrospective matched cohort study from China

Overview of Patient Preferences in the Surgical Management Plan of Early Breast Cancers

Contact Info

Product

Resources

About