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Ten-year trend analysis of breast cancer, oncoplastic, and reconstructive breast surgery in a single institution (2010–2019), what has not changed?

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Abstract

Purpose

There has been a UK national directive to ensure that patients are offered reconstructive surgical options. We aimed to assess any change in oncoplastic practice over a 10-year period.

Methods

The surgical management of 7019 breast cancers was retrospectively assessed at Nightingale Breast Centre, Manchester University UK, from 2010 to 2019. The procedures were categorised into breast conservative surgery (BCS) and mastectomy ± immediate reconstruction. The data were analysed using inclusion and exclusion criteria.

Results

The overall rates of BCS and mastectomy were 60.1% and 39.9% respectively. No statistically significant change in the overall rates of BCS or mastectomy was observed over the last decade (p = 0.08). The rate of simple wide local excision (WLE) decreased from 98.7% to 89.3% (p < 0.001), whilst the rate of therapeutic mammoplasty (TM) increased from 1.3% to 8% (p < 0.01). The rate of chest wall perforator flaps (CWPF) changed from zero to account for 2.7% of all BCS by 2019.

The overall rate of immediate breast reconstruction (IBR) did not significantly change over the study period, but it consistently remained above the national average of 27%. The rate of implant-based IBR increased from 61.3% to 76.5% (p = 0.012), whilst the rate of Latissimus Dorsi (LD) reconstruction decreased from 26.7% to 5.1% (p < 0.05). Additionally, the rate of nipple-sparing mastectomy significantly increased from 5.2% to 24%.

Conclusion

No significant changes in the overall rates of BCS was observed, the rates of advanced breast conservation techniques, nipple-sparing mastectomy, and implant-based IBR all have increased, whilst the use of LD reconstruction decreased.

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Data Availability

No datasets were generated or analysed during the current study.

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Funding

The authors have not disclosed any funding.

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Authors and Affiliations

  1. Nightingale Breast Cancer Centre, Manchester University, NHS Foundation Trust, Manchester, UK

    A. Morad, K. Johnson, I. Birkby, S. Schofield & J. Harvey

  2. Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Hucknall Rd, Nottingham, NG5 1PB, UK

    A. Morad

  3. Centre for Biostatistics, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK

    S. Bate

Authors
  1. A. Morad
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  2. K. Johnson
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  3. S. Bate
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  4. I. Birkby
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  5. S. Schofield
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  6. J. Harvey
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Contributions

AM & JH: study design, data collection, analysis, literature review and discussion. SB: Statistical analysis. Other co authors: data collection.

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Correspondence to A. Morad.

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Morad, A., Johnson, K., Bate, S. et al. Ten-year trend analysis of breast cancer, oncoplastic, and reconstructive breast surgery in a single institution (2010–2019), what has not changed?. Breast Cancer Res Treat (2024). https://doi.org/10.1007/s10549-024-07294-x

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  • DOI: https://doi.org/10.1007/s10549-024-07294-x

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