Breast-Contour-Preserving Procedure as a Multidisciplinary Parameter of Esthetic Outcome in Breast Cancer Treatment in The Netherlands.


Journal

Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 04 01 2019
pubmed: 5 3 2019
medline: 12 9 2019
entrez: 5 3 2019
Statut: ppublish

Résumé

The rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute also, such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR). This study explores these efforts to preserve the patient's breast contour. All patients who underwent surgery for invasive breast cancer in The Netherlands between January 2011 and December 2015 were selected from the Dutch national breast cancer audit (n = 61,309). The breast-contour-preserving procedures (BCPP) rate was defined as the rate of primary BCS, BCS after NAC, or mastectomy with IBR. BCPP rates were calculated and compared by year of diagnosis, age categories, and individual hospitals. The rate of primary BCS remained stable (53%) while the BCPP rate increased from 63% in 2011 to 71% in 2015 due to an increase in patients receiving BCS after NAC and mastectomy with IBR. Primary BCS rates increased with age (from 17% in patients aged < 30 years to 63% in patients aged 60-69 years), while the proportion of patients undergoing mastectomy with IBR decreased from 44% in patients < 30 years to 1% in patients ≥ 70 years. The BCPP rate was similar for all age groups except for patients > 70 years. BCPP rates varied between the different hospitals in The Netherlands, ranging from 47 to 88%. The chance of preserving the breast contour for patients with breast cancer has increased substantially over recent years. BCPP provides a comprehensive parameter of esthetic outcome of breast cancer surgery.

Sections du résumé

BACKGROUND BACKGROUND
The rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute also, such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR). This study explores these efforts to preserve the patient's breast contour.
PATIENTS AND METHODS METHODS
All patients who underwent surgery for invasive breast cancer in The Netherlands between January 2011 and December 2015 were selected from the Dutch national breast cancer audit (n = 61,309). The breast-contour-preserving procedures (BCPP) rate was defined as the rate of primary BCS, BCS after NAC, or mastectomy with IBR. BCPP rates were calculated and compared by year of diagnosis, age categories, and individual hospitals.
RESULTS RESULTS
The rate of primary BCS remained stable (53%) while the BCPP rate increased from 63% in 2011 to 71% in 2015 due to an increase in patients receiving BCS after NAC and mastectomy with IBR. Primary BCS rates increased with age (from 17% in patients aged < 30 years to 63% in patients aged 60-69 years), while the proportion of patients undergoing mastectomy with IBR decreased from 44% in patients < 30 years to 1% in patients ≥ 70 years. The BCPP rate was similar for all age groups except for patients > 70 years. BCPP rates varied between the different hospitals in The Netherlands, ranging from 47 to 88%.
CONCLUSIONS CONCLUSIONS
The chance of preserving the breast contour for patients with breast cancer has increased substantially over recent years. BCPP provides a comprehensive parameter of esthetic outcome of breast cancer surgery.

Identifiants

pubmed: 30830541
doi: 10.1245/s10434-019-07265-3
pii: 10.1245/s10434-019-07265-3
pmc: PMC6510878
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1704-1711

Commentaires et corrections

Type : CommentIn

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Auteurs

Annnelotte van Bommel (A)

Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands. a.c.m.van_bommel@lumc.nl.
Dutch Institute for Clinical Auditing, Leiden, The Netherlands. a.c.m.van_bommel@lumc.nl.

Pauline Spronk (P)

Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Dutch Institute for Clinical Auditing, Leiden, The Netherlands.

Marc Mureau (M)

Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, The Netherlands.

Sabine Siesling (S)

Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands.
Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.

Carolien Smorenburg (C)

Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Rob Tollenaar (R)

Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.
Dutch Institute for Clinical Auditing, Leiden, The Netherlands.

Marie-Jeanne Vrancken Peeters (MJ)

Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Thijs van Dalen (T)

Department of Surgery, Diakonessenhuis Utrecht, Utrecht, The Netherlands.

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