Rates of breast cancer surgery in Canada from 2007/08 to 2009/10: retrospective cohort study

Porter, Geoff; Wagar, Brandon; Bryant, Heather; Hewitt, Maria; Wai, Elaine S.; Dabbs, Kelly; McFarlane, Anne; Rahal, Rami

doi:10.9778/cmajo.20130025

Cited by 33 publications

(42 citation statements)

References 39 publications

(32 reference statements)

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“…In 2004, the eligible age range for screening in NZ was widened to include women aged 45–49 years in addition to the 50–69 year age group, which could partly explain the slightly higher rate of BCS. We have shown fairly stable rates of mastectomy, slightly higher than the reported rate of 39% in Australia over a similar time period, higher than the UK audit data for screen‐detected cancers of 23% from 2013/2014 to 2014/2015, and within variable provincial Canadian rates of 26–69% …”

Section: Discussioncontrasting

confidence: 42%

Surgical treatment of early stage breast cancer in the Auckland and Waikato regions of New Zealand

Campbell

Lao

Blackmore

et al. 2018

ANZ Journal of Surgery

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Background: The aim of this study was to understand the factors influencing the use of surgical options by New Zealand women with newly diagnosed breast cancer. Methods: Using data from the Auckland and Waikato breast cancer registers, we included 11 798 women diagnosed with stage I-III breast cancer from June 2000 to May 2013. The characteristics of women receiving different surgical treatments and having immediate breast reconstruction following mastectomy were examined. A logistic regression was used to estimate the odds ratio of having breast-conserving surgery (BCS) versus mastectomy and immediate post-mastectomy reconstruction. Bilateral breast cancer cases and women with unilateral breast cancer, but who had bilateral surgery, were also identified. Results: Fifty-two percent of women received BCS and 44% had mastectomy over the study period. Key influences associated with BCS were age, mode of diagnosis, socioeconomic status and public or private treatment. Just under half of the women who underwent bilateral surgery did not have bilateral cancer. Nineteen percent of women undergoing mastectomy underwent immediate reconstruction. Implant use increased slightly over the study period but there was a decrease in the use of autologous flap procedures. Conclusion: Surgical management of women with localized breast cancer was generally in line with guidelines, but with potential to further increase the use of breast conservation and immediate reconstruction in suitable cases.

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Section: Discussioncontrasting

confidence: 42%

Surgical treatment of early stage breast cancer in the Auckland and Waikato regions of New Zealand

Campbell

Lao

Blackmore

et al. 2018

ANZ Journal of Surgery

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“…In contrast, during a similar time period in Switzerland, CPM rates remained stable at 7% [8] . In Canada, the only reported data examined national CPM rates between 2007 and 2010 and demonstrated an overall CPM rate of 6% (5% in 2007/2008 to 7% in 2009/2010) -consistent with our institutional results and the rates from Switzerland [8,10] . Interestingly, the factors associated with increased rates of immediate CPM at our institution are similar to those found in the United States literature -suggesting that the patient factors influencing the decision to undergo a CPM are possibly the same between the two countries.…”

Section: Discussionsupporting

confidence: 87%

“…It is possible that in these countries, as well as in Canada, where the health care system is based on a socialized medicine model, and surgeons routinely practice under budgetary restraints; a nonlife-saving surgical service such as CPM may not be as readily available as in the United States. In Canada, lower CPM rates have been noted on a national level compared to the United States [10] , but these rates were obtained through administrative databases and no patient level, surgical procedure detail, or outcomes data were reported [10] . Since CPM rates are known to be influenced by resource factors, such as access to genetic testing and immediate breast reconstruction, and other patient factors such as age [1][2][3]7,8,[11][12][13][14] , examining CPM trends with patient and procedure level data will provide more detailed information on the CPM landscape in Canada.…”

Section: Introductionmentioning

confidence: 99%

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Roberts

Sandhu

Cil

et al. 2016

WJCO

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AIM:To examine trends of contralateral prophylactic mastectomy (CPM) rates at a Canadian academic breast cancer center. METHODS:A single-institution retrospective cohort study was completed. Women of any age who underwent at least a unilateral mastectomy (UM) for primary unilateral breast carcinoma between January 1, 2004 and December 31, 2010 were included. Patients who underwent CPM on the same day as UM were isolated to create two distinct cohorts. Patient and procedure characteristics were compared across groups using R software (version 3.1.0). The percentage of CPMs per year was determined. The Cochrane-Armitage test was used to assess the trend of CPMs over time. A P value of < 0.05 was considered significant. RESULTS:A total of 811 women met the inclusions/ exclusion criteria; 759 (93.6%) underwent UM alone and 52 (6.4%) underwent UM with immediate CPM. The absolute number of procedures (UM and UM + CPM) increased over time, from 83 in 2004 to 147 in 2010 reflecting an increase in mastectomy volume. Annual CPM rates did not increase over time (P = 0.7) and varied between 2.6% to 10.7%.

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“…The majority of research that has reported on CPM rates has been conducted in the United States, where CPM rates have ranged from 4% to 25%. [1][2][3][4] Lower rates of CPM have been reported in Canada (6%) 5 and Europe (3%). 6 Rates of CPM are increasing despite the fact that it does not offer a survival advantage for the majority of women with unilateral breast cancer.…”

Section: Introductionmentioning

confidence: 98%

Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer

Metcalfe

Retrouvey

Kerrebijn

et al. 2019

Cancer

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Background The rates of contralateral prophylactic mastectomy (CPM) are increasing in women with breast cancer. Previous retrospective research has examined clinical and demographic predictors of the uptake of CPM. However, to the authors' knowledge, there has been very little prospective research to date that has examined psychosocial functioning prior to breast cancer surgery to determine whether psychosocial functioning predicts uptake of CPM. The current study was conducted to evaluate demographic, clinical, and psychosocial predictors of the uptake of CPM in women with unilateral breast cancer without a BRCA1 or BRCA2 mutation. Methods Women with unilateral non–BRCA‐associated breast cancer completed questionnaires prior to undergoing breast cancer surgery. Participants completed demographic and psychosocial questionnaires assessing anxiety, depression, cancer‐related distress, optimism/pessimism, breast satisfaction, and quality of life. Pathological and surgical data were collected from medical charts. Results A total of 506 women consented to participate, 112 of whom (22.1%) elected to undergo CPM. Age was found to be a significant predictor of CPM, with younger women found to be significantly more likely to undergo CPM compared with older women (P < .0001). The rate of CPM was significantly higher in women with noninvasive breast cancer compared with those with invasive breast cancer (P < .0001). Women who elected to undergo CPM had lower levels of presurgical breast satisfaction (P = .01) and optimism (P = .05) compared with women who did not undergo CPM. Conclusions Psychosocial functioning at the time of breast cancer surgery decision making impacts decisions related to CPM. Women who have lower levels of breast satisfaction (body image) and optimism are more likely to elect to undergo CPM. It is important for health care providers to take psychosocial functioning into consideration when discussing surgical options.

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Rates of breast cancer surgery in Canada from 2007/08 to 2009/10: retrospective cohort study

Abstract: There is substantial interprovincial variation in surgical care for breast cancer in Canada. Further research is needed to better understand such variation, and continued monitoring should be the focus of quality initiatives.

Cited by 33 publications

References 39 publications

Surgical treatment of early stage breast cancer in the Auckland and Waikato regions of New Zealand

Surgical treatment of early stage breast cancer in the Auckland and Waikato regions of New Zealand

Contralateral prophylactic mastectomy rate stable at major Canadian breast cancer center

Predictors of uptake of contralateral prophylactic mastectomy in women with nonhereditary breast cancer

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