Abstract
BackgroundThe rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute also, such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR). This study explores these efforts to preserve the patient’s breast contour.Patients and MethodsAll patients who underwent surgery for invasive breast cancer in The Netherlands between January 2011 and December 2015 were selected from the Dutch national breast cancer audit (n = 61,309). The breast-contour-preserving procedures (BCPP) rate was defined as the rate of primary BCS, BCS after NAC, or mastectomy with IBR. BCPP rates were calculated and compared by year of diagnosis, age categories, and individual hospitals.ResultsThe rate of primary BCS remained stable (53%) while the BCPP rate increased from 63% in 2011 to 71% in 2015 due to an increase in patients receiving BCS after NAC and mastectomy with IBR. Primary BCS rates increased with age (from 17% in patients aged < 30 years to 63% in patients aged 60–69 years), while the proportion of patients undergoing mastectomy with IBR decreased from 44% in patients < 30 years to 1% in patients ≥ 70 years. The BCPP rate was similar for all age groups except for patients > 70 years. BCPP rates varied between the different hospitals in The Netherlands, ranging from 47 to 88%.ConclusionsThe chance of preserving the breast contour for patients with breast cancer has increased substantially over recent years. BCPP provides a comprehensive parameter of esthetic outcome of breast cancer surgery.
Highlights
The rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR)
Demographic and clinicopathological patient characteristics (age, histological subtype, grade, tumor–node– metastasis (TNM) classification) together with comprehensive multidisciplinary treatment information were collected prospectively for all newly diagnosed Dutch patients with breast cancer in the NABON Breast Cancer Audit (NBCA) since 2011.4 Registration was done by registrars of the Netherlands Cancer Registry and personnel of the individual hospitals
All female patients with primary invasive breast cancer without distant metastases diagnosed between January 1, 2011 and December 31, 2015 were extracted from the NBCA
Summary
The rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR). This study explores these efforts to preserve the patient’s breast contour. The breast-contour-preserving procedures (BCPP) rate was defined as the rate of primary BCS, BCS after NAC, or mastectomy with IBR. The rate of primary BCS remained stable (53%) while the BCPP rate increased from 63% in 2011 to 71% in 2015 due to an increase in patients receiving BCS after NAC and mastectomy with IBR.
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