Type of surgery for early breast cancer and predictive factors an institutional review: A regression model.

Abstract

e12016 Background: Breast conserving surgery (BCS) is the preferred surgical management for most early-stage breast cancer, given the equivalent survival after BCS plus radiation and mastectomy (M). Clinical reports of an increasing trend in mastectomy from some institutional reviews have been published. The aim of this study was to assess correlation of type of surgery with different factors in our cancer registry database. Methods: We retrospectively reviewed the cancer registry data at UTMC for early breast cancer stage I/II from 2006-2010. Patient demographics, tumor characteristics, institution of surgery, academic versus private surgeon were identified and compared. We used univariate analysis to select factors for entry into a multivariate analysis. Multinomial logistic regression analysis was performed to predict the type of surgery (cancer side mastectomy (CSM) versus BCS, bilateral mastectomy (BM) versus BCS based on the above variables. A p-value of < 0.05 was significant and comparisons were two tailed. Results: We identified 506 eligible patients with stage I/II breast cancer. 306(60.5%) had undergone breast conservative surgery (BCS), 91 (18%) patients had cancer side mastectomy (CSM) and 109 (21.5%) patients had bilateral mastectomy (BM). 298 (59%) patients were stage I and 208 (41%) had stage II, 218 (42%) had undergone surgery at academic center versus 298 (58%) at nonacademic institution. Predictors o CSM were stage II (p =0.0193), high-grade tumor (p=0.015), surgeon from academic institution (p=0.64), age (p=0.61). Predictors of BM were surgeon from academic institution (p=0.060), age (p=0.07). Conclusions: This study confirms some known factors like stage, surgeon expertise, as influencing factors in type of local surgery, while at the same time did not show impact of race and other tumor characteristics. Further research of these factors need to confirm the influence on decision making prospectively.