Trends in Surgical Treatment of Early-Stage Breast Cancer Reveal Decreasing Mastectomy Use Between 2003 and 2016 by Age, Race, and Rurality

Citation

Roberson, Mya L.; Nichols, Hazel B.; Olshan, Andrew F.; Wheeler, Stephanie B.; Reeder-Hayes, Katherine E.; & Robinson, Whitney R. (2022). Trends in Surgical Treatment of Early-Stage Breast Cancer Reveal Decreasing Mastectomy Use Between 2003 and 2016 by Age, Race, and Rurality. Breast Cancer Research and Treatment, 193(2), 445-454. PMCID: PMC9098687

Abstract

PURPOSE: To examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America.
METHODS: We identified women diagnosed with localized or regional breast cancer between 2003 and 2016 in the North Carolina Central Cancer Registry (n = 86,776). Using Joinpoint regression we evaluated the average annual percentage change in proportion of women treated with mastectomy versus breast-conserving surgery overall, by age group, among Black women, and for women residing in rural areas.
RESULTS: Overall, the rate of mastectomy usage in the population declined 2.5% per year between 2003 and 2016 (95% CI - 3.2, - 1.7). Over this same time interval, breast-conserving surgery increased by 1.6% per year (95% CI 0.9, 2.2). These temporal trends in surgery were also observed among Black women and rural residing women. Trends in surgery type varied by age group: mastectomy declined over time among women > 50 years, but not among women aged 18-49 at diagnosis.
DISCUSSION: In contrast to national studies that reported increasing use of mastectomy, we found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.

URL

http://dx.doi.org/10.1007/s10549-022-06564-w

Reference Type

Journal Article

Year Published

2022

Journal Title

Breast Cancer Research and Treatment

Author(s)

Roberson, Mya L.
Nichols, Hazel B.
Olshan, Andrew F.
Wheeler, Stephanie B.
Reeder-Hayes, Katherine E.
Robinson, Whitney R.

Article Type

Regular

PMCID

PMC9098687

Data Set/Study

North Carolina Central Cancer Registry

Continent/Country

United States of America

State

North Carolina

Sex/Gender

Women

ORCiD

Olshan - 0000-0001-9115-5128
Robinson, W - 0000-0003-4009-0488