Abstract
Objective:There are limited data concerning the use of mastectomy and associated factors in China in recent years. This study aimed to investigate the uptake of mastectomy and determine the associations between patients’ characteristics and mastectomy among Chinese women with breast cancer. Methods:A retrospective analysis of female breast cancer cases from January 2015 to December 2019 from a tertiary hospital was conducted. Socio-demographic data, clinical data, and surgery types were collected by reviewing the medical record system. Chi-square test, Fisher’s exact test and multivariate logistic regression analysis were used to determine correlations of patients’ characteristics with mastectomy. Results:A total of 1,171 women with breast cancer were identified, and 76.60% of them underwent a mastectomy. The mastectomy rates showed an increase from 70.62% in 2015 to 86.87% in 2017 and then dropped to 71.91% in 2019. Women undergoing mastectomy were older and were more likely to be married and have at least one child. They had an advanced cancer stage, larger tumour size, and more positive lymph nodes and were HER-2-overexpressing. Older age, larger tumour size (2-5 cm), higher cancer stages (stage 2- stage 3) and being positive for HER-2 were the four independent variables that significantly predicted the uptake of mastectomy. Conclusions:Our results showed a wide application of mastectomy in China and uncovered the factors associated with mastectomy uptake from a single-centre experience. Findings suggested the potential overuse of mastectomy among women with early-stage breast cancer, and highlighted the significance of promoting cancer screening in China. Findings could be also used to develop relevant provisions and interventions to facilitate breast cancer treatment decision-making and screening planning.
Highlights
Mastectomy is the total removal of a cancer-affected breast
Our results showed a wide application of mastectomy in China and uncovered the factors associated with mastectomy uptake from a single-centre experience
Mastectomy rates are stably high in Asian regions, such as Malaysia (Wong et al, 2019), Singapore (Chan et al, 2015), Saudi Arabia (Al-Gaithy et al, 2019) and China (Huang et al, 2016), with more than half of breast cancer survivors that have had a mastectomy in these Asian countries
Summary
Mastectomy is the total removal of a cancer-affected breast It is an appropriate treatment for most types of breast cancer. The most recent study specific to the uptake of mastectomy in China was published in 2016, reporting that more than 80% of 18,502 patients with breast cancer received a mastectomy during 1999 and 2013 at a breast cancer centre in Shanghai. The findings from this study suggested significant associations between older age and advanced cancer stage with increasing uptake of mastectomy (Huang et al, 2016). Another multi-centre survey among 4,211 patients with breast cancer was conducted in 2015, reporting high mastectomy rates
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