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Increasing National Mastectomy Rates for the Treatment of Early Stage Breast Cancer

  • Healthcare Policy and Outcomes
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

To study national trends in the mastectomy rate for treatment of early stage breast cancer.

Methods

We analyzed data from the Surveillance, Epidemiology, and End Results database, including 256,081 women diagnosed with T1–2 N0–3 M0 breast cancer from 2000 to 2008. We evaluated therapeutic mastectomy rates by the year of diagnosis and performed a multivariable logistic regression analyses to determine predictors of mastectomy as the treatment choice.

Results

The proportion of women treated with mastectomy decreased from 40.1 to 35.6 % between 2000 and 2005. Subsequently, the mastectomy rate increased to 38.4 % in 2008 (p < 0.0001). Simple logistic regression models demonstrated that mastectomy rates between 2005 and 2008 were moderated by age (p < 0.0001), marital status (p = 0.0230), and geographic location (p < 0.0001). Multivariate logistic regression analysis found that age, race, marital status, geographic location, involvement of multiple regions of the breast, lobular histology, increasing T stage, lymph node positivity, increasing grade, and negative hormone receptor status were independent predictors of mastectomy. Additionally, multivariate analysis confirmed that women diagnosed in 2008 were more likely to undergo mastectomy than women diagnosed in 2005 (odds ratio 1.17, 95 % confidence interval 1.13 to 1.21, p < 0.0001).

Conclusions

There is evidence of a reversal in the previously declining national mastectomy rates, with the mastectomy rate reaching a nadir in 2005 and subsequently rising. Further follow-up to confirm this trend and investigation to determine the underlying cause of this trend and its effect on outcomes may be warranted.

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Acknowledgment

We thank Sana Ahmedani for her assistance with figure/table formatting.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Usama Mahmood MD

  2. School of Nursing, University of Pennsylvania, Philadelphia, PA, USA

    Alexandra L. Hanlon PhD

  3. Department of Cellular and Radiation Oncology, University of Chicago, Chicago, IL, USA

    Matthew Koshy MD

  4. Department of Surgery, University of Maryland, Baltimore, MD, USA

    Robert Buras MD

  5. Department of Medicine, University of Maryland, Baltimore, MD, USA

    Saranya Chumsri MD & Katherine H. Tkaczuk MD

  6. Department of Radiation Oncology, University of Maryland, Baltimore, MD, USA

    Sally B. Cheston MD, William F. Regine MD & Steven J. Feigenberg MD

Authors
  1. Usama Mahmood MD
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  2. Alexandra L. Hanlon PhD
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  3. Matthew Koshy MD
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  4. Robert Buras MD
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  6. Katherine H. Tkaczuk MD
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  7. Sally B. Cheston MD
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  9. Steven J. Feigenberg MD
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Correspondence to Usama Mahmood MD.

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Mahmood, U., Hanlon, A.L., Koshy, M. et al. Increasing National Mastectomy Rates for the Treatment of Early Stage Breast Cancer. Ann Surg Oncol 20, 1436–1443 (2013). https://doi.org/10.1245/s10434-012-2732-5

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  • DOI: https://doi.org/10.1245/s10434-012-2732-5

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