Mastectomy Rates Up in Women Eligible for Lumpectomy
(HealthDay News) — A rising number of early-stage breast cancer patients who are eligible for lumpectomy are nonetheless undergoing mastectomy, according to a study published online November 19 in JAMA Surgery.
Researchers led by Kristy Kummerow, MD, of the Vanderbilt University Medical Center in Nashville, TN, tracked data from the National Cancer Data Base. They found that the percentage of early-stage breast cancer patients who were eligible for breast conservation surgery but underwent mastectomy rose from 34.3% in 1998 to 37.8% in 2011. The largest increases were among patients with lymph node-negative, contained cancers.
Kummerow's team found that younger women were more likely to have a mastectomy regardless of tumor size, while older women were more likely to undergo mastectomy if they had a tumor larger than 2cm. Rates of double mastectomy when cancer had only been detected in one breast also rose – from 1.9% in 1998 to 11.2% in 2011, and rates of double mastectomy for early-stage cancer in one breast increased from 5.4% of mastectomies in 1998 to 29.7% in 2011. Rates of breast reconstruction among women undergoing mastectomy rose from 11.6% in 1998 to 36.4% in 2011, while rates of breast reconstruction among women who had a double mastectomy for early-stage cancer in one breast increased from 36.9 to 57.2%.
One expert believes there may be many reasons driving the trend. "While we have known for quite a long time now that survival from breast cancer is equivalent comparing lumpectomy with mastectomy, there are clearly other forces – such as aesthetics, genetics, and anxiety related to future screening – that are also driving surgical decision-making, especially for younger women with breast cancer," Elisa Port, MD, chief of breast surgery and co-director of the Dubin Breast Center at The Tisch Cancer Institute in New York City, told HealthDay. Port was not involved in the new research.