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Breast Cancer Mastectomy Trends Between 2006 and 2010: Association with Magnetic Resonance Imaging, Immediate Breast Reconstruction, and Hospital Volume

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Analysis of mastectomy rates in breast cancer patients diagnosed between 2006 and 2010 in Germany with focus on impact of breast magnetic resonance imaging (MRI), immediate breast reconstruction (IBR) rates, and hospital volume as possible influencing factors of mastectomy rates.

Methods

Data of a voluntary monitored benchmarking project were used to evaluate mastectomy trends across time in an unselected cohort of breast cancer patients. We used univariate and multivariate logistic regression analysis to identify predictive factors of mastectomy.

Results

A total of 142.863 cases were included into the analysis. There was an overall decrease of 5.9 % (95 % confidence interval 5.1–6.7) in mastectomy trend from 36.5 % in 2006 to 30.6 % in 2010 (P < 0.0001). Known predictive factors were confirmed. Breast MRI (odds ratio 1.42, 95 % confidence interval 1.36–1.47) and small hospitals (<150 cases per year) seem to favor mastectomy. IBR was not associated with mastectomy rates.

Conclusions

Mastectomy rates in comparable health systems differ. Performance of preoperative breast MRI and hospital volume seem to be independent influencing factors for mastectomy rates.

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Acknowledgment

The authors thank all participating hospitals of the WBC for participating in the multicenter analysis; a complete list is available online (http://www.brustcentrum.de).

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Breast Unit, University Hospital, University of Heidelberg, Heidelberg, Germany

    Joerg Heil MD, Akos Z. Szabo MD, Michael Golatta MD, Christoph Domschke MD, Florian Schuetz MD, Markus Wallwiener MD, Christof Sohn MD & Andreas Schneeweiss MD

  2. Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany

    Geraldine Rauch MD

  3. Breast Unit, Humanitas Cancer Center, Milan, Rozzano, Italy

    Carlos A. Garcia-Etienne MD

  4. West German Breast Center Ltd., WBC GmbH, Düsseldorf, Germany

    Mahyar Badiian MD & Hubertus Fries MD

  5. Breast Center of Düsseldorf, Luisenkrankenhaus, Düsseldorf, Germany

    Peter Kern MD & Mahdi Rezai MD

  6. GBG Forschungs GmbH, Neu-Isenburg and Luisenkrankenhaus, Düsseldorf, Germany

    Gunter von Minckwitz MD

Authors
  1. Joerg Heil MD
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  2. Geraldine Rauch MD
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  3. Akos Z. Szabo MD
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  4. Carlos A. Garcia-Etienne MD
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  5. Michael Golatta MD
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  6. Christoph Domschke MD
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  7. Mahyar Badiian MD
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  8. Peter Kern MD
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  9. Florian Schuetz MD
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  10. Markus Wallwiener MD
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  11. Christof Sohn MD
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  12. Hubertus Fries MD
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  13. Gunter von Minckwitz MD
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  14. Andreas Schneeweiss MD
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  15. Mahdi Rezai MD
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Corresponding author

Correspondence to Joerg Heil MD.

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Heil, J., Rauch, G., Szabo, A.Z. et al. Breast Cancer Mastectomy Trends Between 2006 and 2010: Association with Magnetic Resonance Imaging, Immediate Breast Reconstruction, and Hospital Volume. Ann Surg Oncol 20, 3839–3846 (2013). https://doi.org/10.1245/s10434-013-3097-0

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  • DOI: https://doi.org/10.1245/s10434-013-3097-0

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