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Trends in surgical treatment for breast cancer in Germany after the implementation of the mammography screening program

  • Pietro Trocchi
  • Oliver Kuss
  • Vanessa Kääb-Sanyal
  • Oliver Heidinger
  • Andreas StangEmail author
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Abstract

In Germany, the nationwide population-based mammography screening program (MSP) was introduced in 2005 and is full-running since 2010. By 2014, incidence rates for invasive breast cancer were very similar to those of the pre-screening era. Therefore, the ongoing effect of the MSP on breast cancer surgery rates can now be investigated. We analyzed population-based breast-conserving (BCS) and mastectomy (MET) surgery rates (per 100,000) among women aged < 50, 50–69 (eligible for the MSP), and 70+ years among women with in situ and invasive breast cancer during 2005–2015. For invasive breast cancer, both BCS and MET rates slightly increased in the age group < 50 years (38.3 in 2005 vs 42.5 in 2015 and 15.7 vs 18.2, respectively). In contrast, MET rates considerably decreased among women aged 50–69 and 70+ years (92 vs 65.4 and 155.4 vs 122.1, respectively), while BCS rates increased in both age groups (210.6 vs 254.4 and 147.2 vs 187, respectively). For in situ breast cancer, MET rates slightly increased in all age groups. BCS rates slightly increased in women aged < 50, but nearly doubled for women aged 50–69 (26.9 vs 49.1) and markedly increased in the 70+ age group (11.5 vs 16.1). During and after the implementation of MSP, there was a strong shift towards BCS within the screening-eligible age group and for women aged 70+ . Women with invasive breast cancer in these age groups may profit from screening with a decline of MET rates in favor of BCS rates at the expense of higher surgery rates for in situ breast cancer.

Keywords

Breast neoplasms Mastectomy Breast-conserving surgery Germany Mammography Screening 
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Notes

Acknowledgements

This study was funded by German Cancer Aid (Deutsche Krebshilfe) [Grant No. 70112088]. The funding source had no role in the study design, in the collection, analysis and interpretation of data, in the writing of the report, and in the decision to submit the paper for publication.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study formal consent is not required.

Supplementary material

10654_2019_570_MOESM1_ESM.docx (33 kb)
Supplementary material 1 (DOCX 31 kb)

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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Center of Clinical Epidemiology, c/o Institute of Medical Informatics, Biometry and Epidemiology (IMIBE)University Hospital EssenEssenGermany
  2. 2.Institute for Biometrics and EpidemiologyGerman Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine UniversityDüsseldorfGermany
  3. 3.Institute of Medical Statistics, Medical FacultyHeinrich Heine UniversityDüsseldorfGermany
  4. 4.Kooperationsgemeinschaft MammographieBerlinGermany
  5. 5.Cancer Registry North Rhine-WestphaliaBochumGermany
  6. 6.Department of Epidemiology, School of Public HealthBoston UniversityBostonUSA

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