Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Vanderbilt study finds more breast cancer patients opting for mastectomy

20.11.2014

Far more breast cancer patients are choosing to undergo mastectomy, including removal of both breasts, instead of choosing breast conservation surgery even when they have early stage disease that is confined to one breast, a Vanderbilt study shows. In the past decade, there have also been marked trends toward higher proportions of women opting for breast reconstruction.

The rates of increase were steepest among women with lymph node-negative and in situ (contained) disease.

This is a reversal of trends seen since the 1990s when breast conservation surgery (BCS) was found to produce equivalent cancer outcomes and was endorsed as a standard of excellence by a National Institutes of Health Consensus Conference.

The Vanderbilt University study, led by Kristy Kummerow, M.D., and Mary Hooks, M.D., MBA, was published online in the Nov. 19 edition of JAMA Surgery.

Using the National Cancer Data Base, the investigators studied records of more than 1.2 million adult women treated at centers accredited by the American Cancer Society and the American College of Surgeons Commission on Cancer from Jan. 1, 1998, to Dec. 31, 2011.

During that time, a total of 35.5 percent of those women underwent mastectomy. The adjusted odds of mastectomy in BCS-eligible women increased 34 percent during the most recent eight years of the study period. Rates of bilateral mastectomy (removal of both breasts) for cancer in one breast increased from 1.9 to 11.2 percent from 1998 to 2011.

In women undergoing mastectomy, rates of breast reconstruction increased from 11.6 to 36.4 percent in the same time period.

The rise in mastectomy rates in the U.S. was most pronounced among younger women with noninvasive disease, those with smaller tumors, and those with node-negative disease, indicating the cancer was less likely to spread beyond the initial tumor. This suggests that factors unrelated to disease burden or cancer control are influencing women, especially younger patients.

"Our findings of still-increasing rates of mastectomy, breast reconstruction and bilateral mastectomy in women with early-stage breast cancer has implications for physician and patient decision making, as well as quality measurement," said Kummerow.

The authors note that the trend toward breast reconstruction may be explained by multiple factors. The National Accreditation Program for Breast Centers expects that all women undergoing mastectomy be offered reconstruction. And the Women's Health and Cancer Rights Act, passed in 1998, mandated insurance coverage of postmastectomy reconstruction. Prior research found that this law significantly increased the proportion of women insured by Medicare and Medicaid who underwent reconstructive procedures.

The study could not determine the number of patients who have tested positive for mutations in the BRCA gene which greatly increases the risk of developing breast cancer, and may influence women to remove both breasts. The research also could not determine the number of patients whose tumors have been identified as triple-negative. These hormone receptor negative tumors are more aggressive and difficult to treat.

The authors note that further research is needed to understand patient, provider, policy and social factors associated with these trends.

Other investigators for the study include Liping Du, Ph.D., David Penson, M.D., MPH, and Yu Shyr, Ph.D.

The research was supported by the U.S. Department of Veterans Affairs, the Veterans Affairs Office of Academic Affiliations, the Veterans Affairs National Quality Scholars Program, and with use of facilities at Veterans Affairs Tennessee Valley Healthcare System in Nashville.

Craig Boerner | EurekAlert!
Further information:
http://www.vanderbilt.edu

More articles from Studies and Analyses:

nachricht New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)

nachricht Reusable carbon nanotubes could be the water filter of the future, says RIT study
30.03.2017 | Rochester Institute of Technology

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Millions through license revenues

27.04.2017 | Health and Medicine

The TU Ilmenau develops tomorrow’s chip technology today

27.04.2017 | Information Technology

Scientist invents way to trigger artificial photosynthesis to clean air

26.04.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>