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

Abstract

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.

The Uptake and Factors Associated with Mastectomy among Chinese Women with Breast Cancer: A Retrospective Observational Study

“…Age has shown varied effects on breast cancer surgical management across the previous literature, and most of them have indicated that older age is associated with an increased uptake of mastectomy, which is consistent with our results (Huang et al, 2016;Al-Gaithy et al, 2019;Chen et al, 2019). We found that women who were married and had at least one child were significantly more likely to undergo a mastectomy.…”

“…3) Types of surgical procedures. In this study, we considered mastectomy to include simple mastectomy, modified radical mastectomy, total mastectomy or skin/areola/nipple-sparing mastectomy, not otherwise specified (Al-Gaithy et al, 2019). The rate of mastectomy was defined as the percentage of mastectomy among all breast cancer cases.…”

“…With the progress of treatment procedures, mastectomy has been used less in many Western countries, such as the United States (US) (Habermann et al, 2010) and European countries (Garcia-Etienne et al, 2012). However, mastectomy rates are stably high in Asian regions, such as Malaysia (Wong et al, 2019), Singapore (Chan et al, 2015), Saudi Arabia (Al-Gaithy et al, 2019) and China (Huang et al, 2016), with more than half of breast cancer survivors that have had a mastectomy in these Asian countries.…”

Clinical characteristics and the associated risk factors of the development of bilateral breast cancers: A case-control study

“…Mastectomy was the main type of surgery for both the first and second cancers because of late recognition and advanced stages at diagnosis ( Table 2 ). Although general consensus on the optimal surgery approach for patients with bilateral breast cancer is not well established, recent studies have shown that bilateral mastectomy has been performed more frequently in synchronous bilateral cancer [ 5 , 32 , 33 ]. Clinical treatment of bilateral cancer including breast surgery has been suggested to be in line with unilateral breast cancer because the indication, contraindication, and prognosis are similar in patients with bilateral breast cancer treated with breast conservation surgery [ 32 ].…”

Correlation between Shoulder Range of Motion, Upper Extremity Disability and Quality of Life in Female Breast Cancer Survivors Post Modified Radical Mastectomy: A Pilot Study

“…Moreover, adjuvant radiotherapy given to mastectomy site and axilla increases risk of impairment of shoulder function. 9 Upper extremity disability (UED) is one among the foremost troublesome longterm complications of carcinoma treatment 10,11,12 . It is now well established that carcinoma survivors have a high prevalence of arm/shoulder impairments which will persist for several years, and are related to long-term activity limitations, participation restriction, and general quality of life impact.…”