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Am J Surg. 2016 Dec;212(6):1201-1210. doi: 10.1016/j.amjsurg.2016.08.020. Epub 2016 Sep 29.

Trends in mastectomy and reconstruction for breast cancer; a twelve year experience from a tertiary care center.

Author information

1
Section of Surgical Oncology, Department of Surgery, Mayo Clinic Arizona, 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA.
2
Department of Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA.
3
Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
4
Department of Radiation Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA.
5
Section of Surgical Oncology, Department of Surgery, Mayo Clinic Arizona, 5777 E. Mayo Blvd, Phoenix, AZ 85054, USA. Electronic address: pockaj.barbara@mayo.edu.

Abstract

BACKGROUND:

Many surgical options exist for breast cancer, including breast conserving therapy (BCT), mastectomy with reconstruction (MAST+RECON) or without reconstruction (MAST). Long-term results regarding oncologic outcomes are few and primarily retrospective studies.

METHODS:

A retrospective review of a prospectively collected database of patients undergoing breast surgery for breast cancer from 2002 to 2014 was performed. Patients were separated into 3 time periods for analysis: 2002 to 2005, 2006 to 2009, and 2010 to 2014. Recurrence outcomes were compared at 4 years between MAST+RECON patients.

RESULTS:

Two thousand seventy-six patients were identified: 61.2% underwent BCT, 19.7% had MAST, and 19.1% had MAST+RECON. BCT patients were older and had smaller tumors. MAST+RECON increased in prevalence, whereas BCT decreased. Implant-based reconstruction and conservative mastectomy rates increased over the study period. Four-year local recurrence-free rates were similar in nipple-sparing and skin-sparing mastectomy groups.

CONCLUSIONS:

BCT usage has decreased, trending toward immediate, nipple-sparing mastectomy, implant-based reconstruction. Surgeons should be aware of trends to optimally offer patients their surgical options.

KEYWORDS:

Breast cancer; Breast conserving therapy; Breast reconstruction; Mastectomy

PMID:
27866726
DOI:
10.1016/j.amjsurg.2016.08.020
[Indexed for MEDLINE]

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