Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Factors Predictive of Treatment by Australian Breast Surgeons of Invasive Female Breast Cancer by Mastectomy rather than Breast Conserving Surgery

  • Published : 2013.01.31
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Abstract

Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidence limits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (${\leq}10$) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmed in multiple logistic regression analysis. Conclusions: Results confirm previous studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman's choice and access to radiotherapy services.

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References

  1. Abrams JS, Phillips PH, Friedman MA (1995). Meeting highlights: a reappraisal of research results for the local treatment of early stage breast cancer. J Natl Cancer Inst, 87, 1837-45. https://doi.org/10.1093/jnci/87.24.1837
  2. Anderson BO, Yip CH, Smith RA, et al (2008). Guideline implementation for breast healthcare in low-income and middle-income countries: overview of the Breast Health Global Initiative Global Summit 2007. Cancer, 113, 2221-43. https://doi.org/10.1002/cncr.23844
  3. Armitage P, Berry G (1987). Statistical methods in medical research. Oxford: Blackwell Scientific Publications.
  4. Australian Bureau of Statistics (1998). 1996 census of population and housing. Socio-economic index for areas. Canberra: Australian Bureau of Statistics.
  5. Australian Institute of Health and Welfare (2012). Australian cancer incidence and mortality (ACIM) books. Canberra: Australian Institute of Health and Welfare.
  6. Australian Institute of Health and Welfare, Cancer Australia, Australasian Association of Cancer Registries (2008). Cancer Survival and prevalence in Australia: cancers diagnosed from 1982-2004. Cancer Series No. 42. Cat. No. CAN 38. Canberra: Australian Institute of Health and Welfare.
  7. Byrne MJ, Jamrozik K, Parson RW, et al (1993). Breast cancer in Western Australia in 1989. II. Diagnosis and primary management. Aust NZ J Surg, 63, 624-9. https://doi.org/10.1111/j.1445-2197.1993.tb00470.x
  8. Caldon LJ, Collins KA, Wilde DJ, et al (2011). Why do hospital mastectomy rates vary? Differences in the decision making experiences of women with breast cancer. Br J Cancer, 104, 1551-7. https://doi.org/10.1038/bjc.2011.141
  9. Cancer Australia (2012). Study of breast cancer screening characteristics and breast cancer survival in Aboriginal and Torres Strait Islander women of Australia. Sydney: Cancer Australia.
  10. Cancer Institute NSW (2012). New cancer registry statistical reporting. Sydney: Cancer Institute NSW.
  11. Cuncins-Hearn AV, Boult M, Babidge W, et al (2006) National breast cancer audit: overview of invasive breast cancer management. ANZ J Surg, 76, 745-50. https://doi.org/10.1111/j.1445-2197.2006.03846.x
  12. Dixon JM, Mak C (2008). Predictors of mastectomy in a certified breast center- the surgeon is an independent risk factor. Breast J, 14, 321-3. https://doi.org/10.1111/j.1524-4741.2008.00591.x
  13. Dragun AE, Huang B, Tucker TC, Spanos WJ (2012a). Increasing mastectomy rates among all age groups for early stage breast cancer: a 10-year study of surgical choice. Breast J, 18, 318-25. https://doi.org/10.1111/j.1524-4741.2012.01245.x
  14. Dragun AE, Pan J, Riley EC, et al (2012b). Increasing use of elective mastectomy and contralateral prophylactic surgery among breast conservation candidates: a 14-year report from a comprehensive cancer center. Am J Clin Oncol [Epub ahead of print].
  15. Federation European Cancer Societies (2004). New study reveals big disparity between countries in breast conservation rates. Hamburg: European Breast Conference Proceedings, Abstract 362.
  16. Fisher B, Anderson S, Redmond CK, et al (1995). Reanalysis and results after 12 years of follow-up in a randomized clinical trial composing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med, 333, 1456-61. https://doi.org/10.1056/NEJM199511303332203
  17. Freedman GM, Anderson PR, Goldstein LJ, et al (2007). Four-week course of radiation for breast cancer using hypofractionated intensity modulated radiation therapy with an incorporated boost. Int J Radiat Oncol Biol Phys, 68, 347-53. https://doi.org/10.1016/j.ijrobp.2006.12.035
  18. Freedman GM, Anderson PR, Bleicher RJ, et al (2012). Five-year local control in a phase II study of hypofractionated intensity modulated radiation therapy with an incorporated boost for early stage breast cancer. Int J Radiat Oncol Biol Phys [Epub ahead of print].
  19. Gaudette LA, Gao RN, Spence A, et al (2004). Declining use of mastectomy for invasive breast cancer in Canada, 1981-2000. Can J Public Health, 95, 336-40.
  20. Habermann EB, Abbott A, Parsons HM, et al (2010). Are mastectomy rates really increasing in the United States? J Clin Oncol, 28, 3437-41. https://doi.org/10.1200/JCO.2009.27.6774
  21. Hill DJ, Giles GG, Russell IS, Collins JP, Mapperson KJ (1990). Management of primary, operable breast cancer in Victoria. Med J Aust, 152, 67-72.
  22. Hill DJ, White VM, Giles GG, Collins JP, Kitchen PR (1994). Changes in the investigation and management of primary operable breast cancer in Victoria. Med J Aust, 161, 110-1.
  23. Hill D, Jamrozik K, White V, et al (1999). Surgical management of breast cancer in Australia in 1995. Sydney: NHMRC National Breast Cancer Centre.
  24. Katipamula R, Degnim AC, Hoskin T, et al (2009). Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging. J Clin Oncol, 27, 4082-8. https://doi.org/10.1200/JCO.2008.19.4225
  25. Kotwall C, Covington D, Churchill P, et al (1998). Breast conservation surgery for breast cancer at a regional medical center. Am J Surg, 176, 510-4. https://doi.org/10.1016/S0002-9610(98)00254-2
  26. Kricker A (2011). Using linked data to explore quality of care for breast cancer. NSW Pub Health Bull, 12, 110-3.
  27. Lazovich DA, White E, Thomas DB, Moe RE (1991). Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA, 266, 3433-8. https://doi.org/10.1001/jama.1991.03470240055032
  28. Lazovich D, White E, Thomas DB, Moe RE, Taplin S (1997). Change in use of breast-conserving surgery in western Wahington after the 1990 NIH Consensus Development Conference. Arch Surg, 132, 418-23. https://doi.org/10.1001/archsurg.1997.01430280092014
  29. Mandelblatt JS, Berg CD, Merepol NJ, et al (2001). Measuring and predicting surgeons' practice styles for breast cancer treatment in older women. Med Care, 39, 228-42. https://doi.org/10.1097/00005650-200103000-00004
  30. National Breast Cancer Centre (2001). Clinical Practice guidelines for the management of early breast cancer: Second Edition. Canberra: National Health & Medical Research Council.
  31. Roder D, Wang JX, Zorbas H, Kollias J, Maddern G (2010). Survival from breast cancers managed by surgeons participating in the National Breast Cancer Audit of the Royal Australasian College of Surgeons. ANZ J Surg, 80, 776-80. https://doi.org/10.1111/j.1445-2197.2010.05341.x
  32. Roder D, Webster F, Zorbas H, Sinclair S (2012). Breast screening and breast cancer survival in Aboriginal and Torres Strait Islander women of Australia. Asian Pac J Cancer Prev, 13, 147-55. https://doi.org/10.7314/APJCP.2012.13.1.147
  33. Samnakay N, Tinning J, Ives A, et al (2005). Rates for mastectomy are low in women attending a breast-screening programme. ANZ J Surg, 75, 936-9. https://doi.org/10.1111/j.1445-2197.2005.03584.x
  34. South Australian Cancer Registry (2000). Epidemiology of cancer in South Australia. Incidence, mortality and survival 1977 to 1999. Incidence and mortality 1999. Adelaide: Openbook Publ: 138.
  35. StataCorp (2005). Stata Statistical Software. Release 9.2. College Station, Texas: StataCorp LP.
  36. Taylor R, Stubbs JM, Langlands AO, Boyages J (1999). Predictors of mastectomy for women with breast cancer in the Greater Western Region of Sydney. Breast J, 5, 116-21. https://doi.org/10.1046/j.1524-4741.1999.00135.x
  37. Tuttle TM, Habermann EB, Grund EH, Morris TJ, Virnig BA (2007). Increasing use of prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol, 25, 5203-9. https://doi.org/10.1200/JCO.2007.12.3141
  38. US Department Health and Human Services, National Institutes of Health (1990). NIH Consensus Development Program. Treatment of early-stage breast cancer. NIH Consensus Statement On-line. June. 18-21; 8(6) 1-19.
  39. Zorzi M, Puliti D, Vettorazzi M, et al (2006). Mastectomy rates are decreasing in the era of service screening: a population-based study in Italy (1997-2001). Br J Cancer, 95, 1265-8. https://doi.org/10.1038/sj.bjc.6603405

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