- 作者：Carlos A. Garcia-Etienne ; Mariano Tomatis ; Joerg Heil ; Kay Friedrichs ; Rolf Kreienberg ; Andreas Denk ; Marion Kiechle ; Fatemeh Lorenz-Salehi ; Rainer Kimmig ; G¨¹nter Emons ; Mahmoud Danaei ; Volker Heyl ; Uwe Heindrichs ; Christoph J. Rageth ; Wolfgang Janni ; Lorenza Marotti ; Marco Rosselli del Turco ; Antonio Ponti ; eusomaDB Working Group
- 关键词：Mastectomy trends ; Mastectomy rates ; Mastectomy ; Mastectomies ; Trends in Europe ; Rates in Europe ; Surgery trends in Europe ; Surgery for breast cancer ; Breast surgery ; Breast surgery in Europe
- 刊名：European Journal of Cancer
- 出版年：2012
- 出版时间：September, 2012
- 年：2012
- 卷：48
- 期：13
- 页码：1947-1956
- 全文大小：349 K
Introduction
Recent single-institution reports have shown increased mastectomy rates during the last decade. Further studies aiming to determine if these reports could be reflecting a national trend in the United States of America (US) have shown conflicting results. We report these trends from a multi-institutional European database.Patients and methods
Our source of data was the eusomaDB, a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists (EUSOMA). We identified patients with newly diagnosed unilateral early-stage breast cancer (stages 0, I or II) to examine rates and trends in surgical treatment.
Results
A total of 15,369 early-stage breast cancer cases underwent surgery in 13 Breast Units from 2003 to 2010. Breast conservation was successful in 11,263 cases (73.3 % ).
Adjusted trend by year showed a statistically significant decrease in mastectomy rates from 2005 to 2010 (p = 0.003) with a progressive reduction of 4.24 % per year. A multivariate model showed a statistically significant association of the following factors with mastectomy: age <40 or ?70 years, pTis, pT1mi, positive axillary nodes, lobular histology, tumour grade II and III, negative progesterone receptors and multiple lesions.
Conclusion
Our study demonstrates that a high proportion of patients with newly diagnosed unilateral early-stage breast cancer from the eusomaDB underwent breast-conserving surgery. It also shows a significant trend of decreasing mastectomy rates from 2005 to 2010. Moreover, our study suggests mastectomy rates in the population from the eusomaDB are lower than those reported in the US.