PMID- 28797046
OWN - NLM
STAT- MEDLINE
DCOM- 20171009
LR  - 20180511
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 8
DP  - 2017
TI  - Breast conservation surgery versus total mastectomy among women with localized
      breast cancer in Soweto, South Africa.
PG  - e0182125
LID - 10.1371/journal.pone.0182125 [doi]
AB  - PURPOSE: Breast conserving surgery (BCS) has become the preferred surgical option
      for the management of patients with nonmetastatic breast cancer in high-income
      countries. However, little is known about the distribution and determinants of
      BCS in low-and middle-income countries, especially those with high HIV
      prevalence. METHODS: We compared demographic and clinical characteristics of
      female patients who received BCS and those who received total mastectomy (TM) for
      nonmetastatic invasive carcinoma of the breast in Soweto, South Africa,
      2009-2011. We also developed a multivariable logistic regression model of
      predictors of type of surgery. RESULTS: Of 445 patients, 354 (80%) underwent TM
      and 91 (20%) BCS. Of 373 patients screened for HIV, 59 (15.8%) tested positive.
      Eighty-two of 294 patients with stage I/II disease (28%), but just 9 of 151 (6%) 
      with stage III disease had BCS (p<0.001). All women who received BCS (except for 
      seven who received completion mastectomy within 6 weeks of BCS) and 235 (66.4%)
      women who received TM were referred for radiation therapy (RT). In our
      multivariable analysis, age group 50-59 years (OR = 2.28, 95% CI = 1.1-4.8) and
      >/=70 years (OR = 9.55, 95% CI = 2.9-31.2) vs. age group <40 years, stage at
      diagnosis (stage II (OR = 3.79, 95% CI = 1.6-8.2) and stage III (OR = 27.8, 95%
      CI = 9.0-78.8) vs. stage 1, HIV (HIV positive (OR = 3.19, 95% CI = 1.3-7.9) vs.
      HIV negative) and HER2-enriched subtype (OR = 3.50, 95% CI = 1.2-10.1) vs. triple
      negative were independently associated with TM. CONCLUSION: TM was more common
      than BCS among patients with nonmetastatic breast cancer in Soweto, not only
      among patients with locally advanced disease at diagnosis, but also among women
      with stage I and II disease.
FAU - Cubasch, Herbert
AU  - Cubasch H
AD  - Department of Surgery, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg,
      South Africa.
AD  - Wits Health Consortium, Johannesburg, South Africa.
FAU - Joffe, Maureen
AU  - Joffe M
AD  - Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg,
      South Africa.
AD  - Wits Health Consortium, Johannesburg, South Africa.
AD  - Department of Paediatrics, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
FAU - Ruff, Paul
AU  - Ruff P
AD  - Wits Health Consortium, Johannesburg, South Africa.
AD  - Division of Medical Oncology, Department of Internal Medicine, Faculty of Health 
      Sciences, University of the Witwatersrand, Johannesburg, South Africa.
AD  - Department of Internal Medicine, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
FAU - Dietz, Donald
AU  - Dietz D
AD  - Department of Medicine, College of Physicians and Surgeons, Columbia University, 
      New York, New York, United States of America.
FAU - Rosenbaum, Evan
AU  - Rosenbaum E
AD  - Department of Medicine, College of Physicians and Surgeons, Columbia University, 
      New York, New York, United States of America.
FAU - Murugan, Nivashni
AU  - Murugan N
AD  - Department of Surgery, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg,
      South Africa.
FAU - Chih, Ming Tsai
AU  - Chih MT
AD  - Department of Surgery, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
AD  - Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg,
      South Africa.
FAU - Ayeni, Oluwatosin
AU  - Ayeni O
AD  - Batho Pele Breast Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg,
      South Africa.
AD  - Wits Health Consortium, Johannesburg, South Africa.
FAU - Dickens, Caroline
AU  - Dickens C
AD  - Department of Internal Medicine, Faculty of Health Sciences, University of the
      Witwatersrand, Johannesburg, South Africa.
FAU - Crew, Katherine
AU  - Crew K
AD  - Department of Medicine, College of Physicians and Surgeons, Columbia University, 
      New York, New York, United States of America.
AD  - Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons,
      Columbia University, New York, New York, United States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, New York, United States of America.
FAU - Jacobson, Judith S
AU  - Jacobson JS
AD  - Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons,
      Columbia University, New York, New York, United States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, New York, United States of America.
FAU - Neugut, Alfred
AU  - Neugut A
AD  - Department of Medicine, College of Physicians and Surgeons, Columbia University, 
      New York, New York, United States of America.
AD  - Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons,
      Columbia University, New York, New York, United States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, New York, United States of America.
LA  - eng
GR  - R01 CA192627/CA/NCI NIH HHS/United States
PT  - Journal Article
DEP - 20170810
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Breast/pathology/*surgery
MH  - Breast Neoplasms/pathology/*surgery
MH  - Female
MH  - Humans
MH  - Mastectomy/*methods
MH  - Mastectomy, Segmental/*methods
MH  - Middle Aged
MH  - South Africa
PMC - PMC5552305
EDAT- 2017/08/11 06:00
MHDA- 2017/10/11 06:00
CRDT- 2017/08/11 06:00
PHST- 2017/02/02 00:00 [received]
PHST- 2017/07/12 00:00 [accepted]
PHST- 2017/08/11 06:00 [entrez]
PHST- 2017/08/11 06:00 [pubmed]
PHST- 2017/10/11 06:00 [medline]
AID - 10.1371/journal.pone.0182125 [doi]
AID - PONE-D-17-04314 [pii]
PST - epublish
SO  - PLoS One. 2017 Aug 10;12(8):e0182125. doi: 10.1371/journal.pone.0182125.
      eCollection 2017.