Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008)

Sao Paulo Medical Journal

Débora Balabram²  Fábio Braga Araújo¹  Simone Souza Porto¹  Joyce Soares Rodrigues¹  Atila Silva Sousa¹  Arminda Lucia Siqueira¹  Helenice Gobbi¹ 

[1] ,Universidade Federal de Minas Gerais Universidade Federal de Minas Gerais Department of Anatomical PathologyBelo Horizonte Minas Gerais ,Brazil

关键词: Mastectomy;    Mastectomy;    segmental;    Breast neoplasms;    Brazil;    Neoplasm staging;    Mastectomia;    Mastectomia segmentar;    Neoplasias da mama;    Brasil;    Estadiamento de neoplasias;   

DOI  :  10.1590/S1516-31802012000600002

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients' age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.

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