Chan SWW, Cheung C, Chan A, Cheung PSY. Surgical options for Chinese patients with early invasive breast cancer: Data from the Hong Kong Breast Cancer Registry.
Asian J Surg 2016;
40:444-452. [PMID:
27209473 DOI:
10.1016/j.asjsur.2016.02.003]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND
Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancer patients.
METHODS
Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I-II breast cancer patients who had surgical treatments were included in this retrospective study.
RESULTS
Our multivariate logistic regression shows that people who were younger (age < 40 years: OR, 1.5; 95% CI, 1.1-2.1; p = 0.010), more educated (undergraduate/postgraduate: OR, 2.8; 95% CI, 1.7-4.4; p < 0.0001), never married (OR, 1.5; 95% CI, 1.1-1.9; p = 0.002), had regular mammography screening (OR, 1.5; 95% CI, 1.3-1.8; p < 0.0001), had screen-detected cancers (OR, 1.3; 95% CI, 1.0-1.6; p = 0.031), and who underwent surgery at a private medical service facility (OR, 1.8; 95% CI, 1.6-2.2; p < 0.0001) were more likely to receive BCS. In addition, people who were younger (age < 40 years: OR, 15.9; 95% CI, 6.5-39.2; p < 0.0001), more educated (undergraduate/postgraduate: OR, 26.8; 95% CI, 3.6-201.4; p = 0.001), had regular mammography screening (OR, 1.6; 95% CI, 1.1-2.3; p = 0.008), had screen-detected cancers (OR, 2.1; 95% CI, 1.4-3.3; p = 0.001), and had smaller tumor (≤ 2.0 cm: OR, 0.39; 95% CI, 0.20-0.76; p = 0.005) were more likely to have reconstruction after MTX.
CONCLUSION
Chinese patients have lower BCS and breast reconstruction rate. Besides cultural difference, patient-related factors such as age, education, marital status, mammography screening, the use of private medical facilities, and clinical characteristics including smaller tumor size and peripherally located tumor were significant predictors for type of surgical treatments in Chinese women with early breast cancer.
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