Details:

Alternative Title:
Clin Breast Cancer
Publisher's site:
http://dx.doi.org/10.1016/j.clbc.2015.08.004
Personal Author:
Freedman, Rachel A. ; Kouri, Elena M. ; West, Dee W. ; Rosenberg, Shoshana ; Partridge, Ann H. ; ... More +
Freedman, Rachel A. ; Kouri, Elena M. ; West, Dee W. ; Rosenberg, Shoshana ; Partridge, Ann H. ; Lii, Joyce ; Keating, Nancy L. Less -
Description:
Background

The reasons for increasing rates of bilateral mastectomy for unilateral breast cancer are incompletely understood and associations of disease stage with bilateral surgery have been inconsistent. We examined associations of clinical and sociodemographic factors, including stage, with surgery type and reconstruction receipt among women with breast cancer.

Patients/Methods

We surveyed a diverse population-based sample of women from northern California cancer registries with stage 0–III breast cancer diagnosed during 2010–2011 (participation rate=68.5%). Using multinomial logistic regression, we examined factors associated with bilateral and unilateral mastectomy (vs. breast conservation [BCS]), adjusting for tumor and sociodemographic characteristics. In a second model, we examined factors associated with reconstruction for mastectomy-treated patients.

Results

Among 487 participants, 58% had BCS, 32% had unilateral mastectomy, and 10% underwent bilateral mastectomy. In adjusted analyses, women with stage III (vs. stage 0) cancers had higher odds of bilateral mastectomy (odds ratio [O.R]=8.28; 95% Confidence Interval=2.32–29.50); women with stage II and III (vs. stage 0) disease had higher odds of unilateral mastectomy. Higher (vs. lower) income was also associated with bilateral mastectomy, while age ≥60 (vs. <50) was associated with lower odds of bilateral surgery. Among mastectomy-treated patients (n=206), bilateral mastectomy, unmarried status, higher education and income were all associated with reconstruction (Ps<0.05).

Conclusion

In this population-based cohort, women with the greatest risk of distant recurrence were most likely to undergo bilateral mastectomy despite a lack of clear medical benefit, raising concern for over-treatment. Our findings highlight the need for interventions to assure women are making informed surgical decisions.


Subject:
[+]
Age Factors
Article
Breast Neoplasms
Female
Follow-Up Studies
Humans
Mammaplasty
Mastectomy, Segmental
Middle Aged
Neoplasm Staging
Prognosis
Risk Factors
Surveys And Questionnaires

Source:
Clin Breast Cancer. 16(2):105-112.
Pubmed ID:
26410475
Pubmed Central ID:
PMC5538374
Document Type:
Journal Article
Funding:
HHSN261201000034C/PHS HHS/United States ; U58DP003862-01/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035C/PHS HHS/United States ; K24CA181510/CA/NCI NIH HHS/United States ; HHSN261201000140C/PHS HHS/United States ; ... More +
HHSN261201000034C/PHS HHS/United States ; U58DP003862-01/DP/NCCDPHP CDC HHS/United States ; HHSN261201000035C/PHS HHS/United States ; K24CA181510/CA/NCI NIH HHS/United States ; HHSN261201000140C/PHS HHS/United States ; K24 CA181510/CA/NCI NIH HHS/United States Less -
Place as Subject:
California
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:7c82d983bf6246193e1b04e8a8718815ba105a698f53987328ae33f99b48e295
File Type:

Supporting Files

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