Trends of mastectomy and breast-conserving surgery and related factors in female breast cancer patients treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2009-2017: A retrospective cohort study.

Zuhoor K Al –Gaithy,Bassam E Yaghmoor,Khalid A Alshehri,Abed A Saqah,Hisham Z Alshehri,Mohammed I Koumu

doi:10.1016/j.amsu.2019.03.012

Zuhoor K Al –Gaithy, Bassam E Yaghmoor + Show 4 more

Open Access

https://doi.org/10.1016/j.amsu.2019.03.012

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Abstract

BackgroundBreast cancer is the most common cancer in women and accounts for 14.7% of cancer-related deaths among females worldwide. Its core management includes surgical removal of the tumor either by breast-conserving surgery (BCS) or mastectomy. Choosing between these two procedures may be influenced by factors that are not studied in our region. We aimed to determine the prevalence of BCS and mastectomy and the factors that may influence the choice of procedure.MethodsThis retrospective study was carried out by reviewing the records of female breast cancer patients who underwent BCS or mastectomy at between 2009 to June 2017, excluding those with metastasis or recurrence. Frequencies and multivariate tests were used for detecting correlations between procedures and demographic, clinicopathological, and radiological factors.ResultsOf 335 patients (mean age 52.75 ± 12.2 years), 62.4% had mastectomy and 37.6% had BCS. Modified radical mastectomy accounted for 70.8% of mastectomies. Multivariate analysis showed non-Saudi nationality (P = 0.002), multifocal (P = 0.0001) and multicentric tumors (P = 0.0001), large tumor size (P = 0.0001), tumor stages IIIA (P = 0.005) and IIIB (P = 0.014), positive HER2 (0.009), and triple-negative receptor status (P = 0.010) significantly correlated with mastectomy.ConclusionMastectomy has a much higher prevalence than BCS in our study mainly due to advanced tumor stage at the time of diagnosis. This emphasizes the urgent need for early detection of breast cancer to move towards BCS, with education and increasing awareness of breast cancer and the surgical options, especially that it is more common in a significantly younger population in our area.

Highlights

Breast cancer is the most common cancer in women across the world, accounting for 25.2% of cancer cases among females and 14.7% of cancer-related deaths among females worldwide [1]
45 patients were excluded from the study; 24 of them had metastasis, 14 had recurrences, 4 had recurrence and metastasis, and 3 patients were pregnant at the time of diagnosis (Fig. 1)
Our study revealed that the prevalence of mastectomy is higher than breastconserving surgery (BCS) in the surgical treatment of breast cancer, which is reversed from the pattern in the US and Europe over the years, with 13.1% up to 40.1% BCS vs 62.4% mastectomies [13,14,28,29,30]

Summary

Introduction

Breast cancer is the most common cancer in women across the world, accounting for 25.2% of cancer cases among females and 14.7% of cancer-related deaths among females worldwide [1]. Its core management includes surgical removal of the tumor either by breastconserving surgery (BCS) or mastectomy Choosing between these two procedures may be influenced by factors that are not studied in our region. Conclusion: Mastectomy has a much higher prevalence than BCS in our study mainly due to advanced tumor stage at the time of diagnosis. This emphasizes the urgent need for early detection of breast cancer to move towards BCS, with education and increasing awareness of breast cancer and the surgical options, especially that it is more common in a significantly younger population in our area

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