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 Some brain tumors may respond to immunotherapy, new study suggests
11.12.2018 | Columbia University Irving Medical Center

nachricht Climate change and air pollution damaging health and causing millions of premature deaths
30.11.2018 | International Institute for Applied Systems Analysis (IIASA)

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: Data use draining your battery? Tiny device to speed up memory while also saving power

The more objects we make "smart," from watches to entire buildings, the greater the need for these devices to store and retrieve massive amounts of data quickly without consuming too much power.

Millions of new memory cells could be part of a computer chip and provide that speed and energy savings, thanks to the discovery of a previously unobserved...

Im Focus: An energy-efficient way to stay warm: Sew high-tech heating patches to your clothes

Personal patches could reduce energy waste in buildings, Rutgers-led study says

What if, instead of turning up the thermostat, you could warm up with high-tech, flexible patches sewn into your clothes - while significantly reducing your...

Im Focus: Lethal combination: Drug cocktail turns off the juice to cancer cells

A widely used diabetes medication combined with an antihypertensive drug specifically inhibits tumor growth – this was discovered by researchers from the University of Basel’s Biozentrum two years ago. In a follow-up study, recently published in “Cell Reports”, the scientists report that this drug cocktail induces cancer cell death by switching off their energy supply.

The widely used anti-diabetes drug metformin not only reduces blood sugar but also has an anti-cancer effect. However, the metformin dose commonly used in the...

Im Focus: New Foldable Drone Flies through Narrow Holes in Rescue Missions

A research team from the University of Zurich has developed a new drone that can retract its propeller arms in flight and make itself small to fit through narrow gaps and holes. This is particularly useful when searching for victims of natural disasters.

Inspecting a damaged building after an earthquake or during a fire is exactly the kind of job that human rescuers would like drones to do for them. A flying...

Im Focus: Topological material switched off and on for the first time

Key advance for future topological transistors

Over the last decade, there has been much excitement about the discovery, recognised by the Nobel Prize in Physics only two years ago, that there are two types...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

ICTM Conference 2019: Digitization emerges as an engineering trend for turbomachinery construction

12.12.2018 | Event News

New Plastics Economy Investor Forum - Meeting Point for Innovations

10.12.2018 | Event News

EGU 2019 meeting: Media registration now open

06.12.2018 | Event News

 
Latest News

Data use draining your battery? Tiny device to speed up memory while also saving power

14.12.2018 | Power and Electrical Engineering

Tangled magnetic fields power cosmic particle accelerators

14.12.2018 | Physics and Astronomy

In search of missing worlds, Hubble finds a fast evaporating exoplanet

14.12.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>