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 Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

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: Salmonella as a tumour medication

HZI researchers developed a bacterial strain that can be used in cancer therapy

Salmonellae are dangerous pathogens that enter the body via contaminated food and can cause severe infections. But these bacteria are also known to target...

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

3rd Symposium on Driving Simulation

23.10.2017 | Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

 
Latest News

Microfluidics probe 'cholesterol' of the oil industry

23.10.2017 | Life Sciences

Gamma rays will reach beyond the limits of light

23.10.2017 | Physics and Astronomy

The end of pneumonia? New vaccine offers hope

23.10.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>