Methods: Researchers used the Surveillance, Epidemiology, and End Results (SEER) database to identify women diagnosed with stage T1-2, N0-3 invasive breast cancer who had surgery between 2000 and 2008. Patient and tumor characteristics were compared for women undergoing mastectomy or breast conserving surgery.
Results: The findings were published in Annals of Surgical Oncology 2013; pages 1436 to 43. A total of 256,081 patients were identified. Overall 38% had mastectomy, and 61% had breast conserving surgery. The proportion treatment with mastectomy dropped from 40% in 2000 to 36% in 2005. Subsequently, the mastectomy rate increased to 38% in 2008.
Predictors of mastectomy included: Year of diagnosis, age (younger>older>middle aged), race (Asian/Pacific Islander>Hispanic>white>black), marital status (unmarried>married), geographic location, involvement of multiple regions of the breast, lobular type breast cancer, increasing T stage, lymph node involvement, increasing grade, and negative progesterone receptor (PR) status.
My take: Mastectomy rates initially decreased after 2000 in the USA, but they have increased since. MRI may be leading to more mastectomies, but we still don’t have data that MRI improves long-term outcomes. I’m Dr. Michael Hunter.
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