Breast-contour preserving procedures for early-stage breast cancer: a population-based study of the trends, variation in practice and predictive characteristics in Denmark and the Netherlands

Abstract

Purpose Breast-contour preservation (BCP) is possible for most women treated for early-stage breast cancer. BCP can be defined as primary breast-conserving treatment (BCT), neoadjuvant chemotherapy (NAC) followed by BCT and immediate postmastectomy breast reconstruction (IBR). This study provides insight in current BCP strategies in Denmark and the Netherlands and aims to identify opportunities for improvement within both countries. Methods A total of 92,881 patients with early-stage breast cancer who were operated in Denmark and the Netherlands between 2012 and 2017 were selected from the Danish Breast Cancer Group and the Dutch National Breast Cancer Audit databases. BCP procedures and predictive factors were analyzed within and between both countries. Results BCP was achieved in 76.7% (n = 16,355) of the Danish and in 74.5% (n = 53,328) of the Dutch patients. While BCP rate did not change significantly over time in Denmark (p = 0.250), a significant increase in BCP rate from 69.5% in 2012 to 78.5% in 2017 (p < 0.001) was observed in the Netherlands. In both countries, variation in BCP rates between hospitals decreased over time. NAC followed by BCT and postmastectomy IBR was substantially more often used in the Netherlands compared to Denmark, specifically in patients younger than 50 years. Conclusions In more than 75% of all Danish and Dutch patients, surgically treated for early-stage breast cancer, the breastcontour was preserved. The different use of BCP strategies within Denmark and the Netherlands and the differences observed between hospitals in both countries emphasize the need for more (inter)national consensus on treatment modalities.

Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study

“…However, the study has some important limitations. First, the use of neoadjuvant chemotherapy has been increasing over time [ 18 , 19 ], so the decrease in chemotherapy use during the COVID-19 period may be an underestimation. Second, we did not consider hospital transfers when calculating the number of patients hospitalized with COVID-19 in each region, although we have no reason to doubt that our data offer a good representation of the true burden of COVID-19 in each region.…”

The Uptake and Factors Associated with Mastectomy among Chinese Women with Breast Cancer: A Retrospective Observational Study

“…Unlike China, BCS is the major surgical procedure used to treat breast cancer in most Western countries, and the percentage of women undergoing mastectomy has been declining (Katipamula et al, 2009;Garcia-Etienne et al, 2012;Albornoz et al, 2015;Heeg et al, 2020). Although the application of unilateral mastectomy was declining, the reconstructive mastectomy and prophylactic mastectomy were increasing, leading to the fluctuation in mastectomy rates (Albornoz et al, 2015).…”

Oncoplastic Breast Conserving Surgery: Is There a Need for Standardization? Results of a Nationwide Survey

“…To gain more insight into the various ways of maintaining breast contour, in 2016, the composite indicator “breast contour-preserving procedure” was introduced as a quality measure that combines the parameters primary BCS, BCS after neoadjuvant chemotherapy, and mastectomy with IBR [ 9 ]. This indicator showed that more than 70% of the women with breast cancer maintained their breast contour following initial mastectomy or BCS [ 9 , 12 ].…”