Trends in mastectomy and reconstruction for breast cancer; a twelve year experience from a tertiary care center

Am J Surg. 2016 Dec;212(6):1201-1210. doi: 10.1016/j.amjsurg.2016.08.020. Epub 2016 Sep 29.

Abstract

Background: Many surgical options exist for breast cancer, including breast conserving therapy (BCT), mastectomy with reconstruction (MAST+RECON) or without reconstruction (MAST). Long-term results regarding oncologic outcomes are few and primarily retrospective studies.

Methods: A retrospective review of a prospectively collected database of patients undergoing breast surgery for breast cancer from 2002 to 2014 was performed. Patients were separated into 3 time periods for analysis: 2002 to 2005, 2006 to 2009, and 2010 to 2014. Recurrence outcomes were compared at 4 years between MAST+RECON patients.

Results: Two thousand seventy-six patients were identified: 61.2% underwent BCT, 19.7% had MAST, and 19.1% had MAST+RECON. BCT patients were older and had smaller tumors. MAST+RECON increased in prevalence, whereas BCT decreased. Implant-based reconstruction and conservative mastectomy rates increased over the study period. Four-year local recurrence-free rates were similar in nipple-sparing and skin-sparing mastectomy groups.

Conclusions: BCT usage has decreased, trending toward immediate, nipple-sparing mastectomy, implant-based reconstruction. Surgeons should be aware of trends to optimally offer patients their surgical options.

Keywords: Breast cancer; Breast conserving therapy; Breast reconstruction; Mastectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Mammaplasty / trends*
  • Mastectomy / trends*
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Retrospective Studies
  • Tertiary Care Centers*
  • Time Factors
  • Treatment Outcome
  • Young Adult