Mastectomy patterns, but not rates, are changing in the treatment of early breast cancer. Experience of a single European institution on 2315 consecutive patients

作者：Fancellu Alessandro^*; Sanna Valeria; Cottu Pietrina; Feo Cladio F; Scanu Antonio M; Farina Giulia; Bulla Antonio; Spanu Angela; Paliogiannis Panagiotis; Porcu Alberto

来源：Breast, 2018, 39: 1-7.

DOI：10.1016/j.breast.2018.02.003

• Mastectomy
• Breast conservation
• Early breast cancer
• Breast reconstruction
• Trends

Background: Recent literature reports that rates of mastectomy are increasing in early breast cancer. However, data from European institutions are limited and revealed conflicting results. We report on 15-year trends of mastectomy, mastectomy plus immediate reconstruction and contralateral prophylactic mastectomy (CPM) at an academic institution.
Methods: We identified women diagnosed with unilateral early breast cancer at stage 0-IIa, with tumour size <= 4 cm, between 2002 and 2016. Trends were assessed using the Cochranee-Armitage test. Multi-variable logistic regression was used to identify factors associated with receipt of mastectomy plus immediate reconstruction.
Results: A total of 2315 patients were identified. Of them, 65.7% underwent breast conserving surgery (BCS), while 34.3% underwent mastectomy as upfront surgery. Two point four per cent also received CPM. Immediate reconstruction was performed in 36.0% of patients receiving mastectomy. There was no change in trends of mastectomy over the 15 years studied (p = 0.69), as well as in trends of patients undergoing CPM (p = 0.44). In contrast, rates of immediate reconstruction rose significantly over the study period (from 12.2% in 2002 to 62.7% in 2016, p < 0.0001). Women were more likely to receive mastectomy plus immediate reconstruction if they were aged 50 years or younger, or had tumours larger than 2 cm, or had non-invasive carcinoma.
Conclusions: Our study suggests that rates of both mastectomy and CPM in early breast cancer are not increasing, while use of immediate reconstruction is on the rise.

• 出版日期2018-6