Kirurgisk behandling av brystkreft i Norge 2003–18

Abstract

Breast-conserving surgery is recommended in Norway and internationally in cases of early-stage breast cancer. We analysed the surgical methods used for breast-cancer patients by hospital providing treatment, age at the time of diagnosis, detection method and histopathological characteristics of the tumours in the period 2003 to 2018. Data on women of all ages diagnosed with invasive breast cancer (n = 47 004) were retrieved from the Cancer Registry of Norway's databases. We excluded women with distant metastases at the time of diagnosis (n = 1 773) and those for whom no surgical method was recorded (n = 2 638). The detection method was defined as breast cancer detected by screening, in inter-screening intervals, or outside BreastScreen Norway. The surgical methods chosen were compared by means of descriptive analyses. Slightly over half (23 661 of 42 593, i.e. 55.6%) of the women in whom breast cancer was detected in the study period underwent breast-conserving surgery. The percentage increased from 1 189/2 423 (49.1%) in 2003 to 2 070/2 958 (70.0%) in 2018. There were large differences across hospitals. In the period 2015-2018 we found the highest proportion of breast-conserving surgery, 175/187 (93.6%) for breast cancer detected by screening to be performed at Ålesund Hospital, and the lowest proportion, 121/351 (34.5%) among women with breast cancer detected outside BreastScreen Norway, to be performed at Radiumhospitalet. Breast-conserving surgery was used most frequently on women with small tumours without spreading to axillary lymph nodes. We found considerable differences in the surgical methods used across hospitals and for different detection methods.