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Development and trends of surgical modalities for breast cancer in China: a review of 16-year data.

Abstract：

BACKGROUND:Surgery is the most important treatment for nonmetastatic breast cancer; however, the utilization of modern surgical techniques in management of breast cancer in mainland China has not been reported. METHODS:The medical records of 5887 consecutive breast cancer patients treated surgically in the past 16 years were reviewed retrospectively; the utilization of different surgical modalities and associated clinical outcomes were analyzed. RESULTS:Median age of all patients was 50 (range 16-92). About 1015 patients were staged as 0-I, 3569 stage II, 517 stage III, and 786 cases could not be staged. Extensive radical mastectomy (ERM), radical mastectomy (RM), modified radical mastectomy (MRM), simple mastectomy (SM), and breast-conserving surgery (BCS) were used in 8%, 27.2%, 55.7%, 1.5%, and 6.3% of patients, respectively. In addition, 1.3% of patients received breast reconstruction. The proportion of early-stage breast cancer increased, and the surgery patterns varied. MRM gradually replaced ERM and RM. The prevalence of BCS began to increase from the mid-1990s and currently represents about 12%. The prevalence of reconstruction also increased and now accounts for 5%. Age, pathologic pattern, and TNM staging affected the choice of surgery modalities markedly. Although patients receiving RM/ERM had worse survival than those receiving BCS/MRM, the survival outcomes of these four groups were similar in the early-stage population. CONCLUSIONS:MRM remains the most-used surgical modality in operable breast cancer, although the utilization of BCS for early-stage disease has increased rapidly in last decade. Reconstruction following mastectomy as an alternative to BCS is available. Breast-conserving therapy (BCT) and MRM provide similar local controls and long-term survival for breast cancer. Selection of appropriate candidates for a certain surgery requires an assessment of the patient's age and clinical and pathological characteristics of the tumor.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Yu KD,Di GH,Wu J,Lu JS,Shen KW,Shen ZZ,Shao ZM

doi

10.1245/s10434-007-9436-2

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

2502-9

issue

eissn

1068-9265

issn

1534-4681

journal_volume

pub_type

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Development and trends of surgical modalities for breast cancer in China: a review of 16-year data.