The current diagnosis and treatment strategy of breast cancer based on multicenter retrospective data in Shaanxi province

Abstract

Background: Breast cancer is a common malignancy, and early detection coupled with standardized treatment is crucial for patient survival and recovery. This study aims to scrutinize the current state of breast cancer diagnosis and treatment in Shaanxi Province, providing valuable insights into the local practices and outcomes. Methods: We selected 25 hospitals that typically represent the current diagnosis and treatment strategy of breast cancer in Shaanxi(a province in northwest China. The questionnaire comprised sections on fundamental information, outpatient consultations, breast-conserving surgery, neoadjuvant therapy, sentinel lymph node biopsy, breast reconstruction surgery, and adjuvant therapy. Results: 25 hospitals were selected in Shaanxi, 17 are located in Xi'an. A total of 6665 breast cancer operations were performed in these 25 hospitals in 2021. The overall proportion of breast-conserving surgery (BCS) is 23.6%.There was a statistically significant positive correlation between the annual volume of breast cancer surgery and the implementation rate of BCS (p= 0.004).A total of 2882 cases of neoadjuvant treatment accounted for 43.24% of breast cancer patients treated with surgery in 2017. Hospitals in Xi'an performed more neoadjuvant therapy for patients with breast cancer compared to other districts (p= 0.008).15 (60%) hospitals routinely perform axillary SLNB for more than 50% of patients with cN0 disease. There was a significantly positive correlation between outpatient visits and the implementation rate of SLNB (p= 0.005). 14 hospitals in Shaanxi performed reconstructive surgery. The breast reconstruction (BR) after mastectomy was more than 10%. Conclusions: Breast conserving surgery, adjuvant and neoadjuvant therapy and sentinel lymph node biopsy in central hospitals in Shaanxi province have reached the national average level. Moreover, hospitals in Xi 'an have surpassed this average. However, a disparity is observed in the development of breast reconstruction surgery when compared to top-tier hospitals.