Trends and patterns of breast conservation treatment in Hong Kong: 1994-2007.
OBJECTIVE
Breast conservation treatment (BCT) was quite unpopular in Hong Kong until the early 1990s, but the trends and patterns of BCT use in the past 14 years have not been studied since. The purpose of this study was to identify the latest trends and patterns.


METHODS
All consecutive cases of female breast cancer referred to a community oncology center in Hong Kong between 1994 and 2007 were retrospectively reviewed. Of the 2,375 women with T1-2 invasive breast cancer who underwent surgery, 1,137 (48%) had T1 (</=2 cm) disease and 1,238 (52%) had T2 (>2 cm-</=5 cm) disease. Median patient age was 51 years (range, 24-95 years); 65% patients had their surgery in public hospitals.


RESULTS
Of the total patient cohort, 2,153 (91%) patients presented with palpable breast masses and only 104 (4%) with mammographically detected cancers. Overall, 721 (30%) and 1,654 (70%) patients underwent BCT and mastectomy, respectively. There was no significant increase in the BCT rates (31%, SD 5%; p = 0.804) or mammographic detection rates (5%, SD 1%; p = 0.125) in Hong Kong between 1994 and 2007. In multivariate analyses, age </=50 years (OR 2.479; p < 0.001), mammographically detected tumors (OR 1.868; p = 0.007), T1 tumors (OR 3.159; p < 0.001), surgeries in private hospitals (OR 1.288; p = 0.018), and negative nodal status (OR 1.886; p < 0.001) were independent factors predictive of a higher likelihood of a woman having BCT.


CONCLUSIONS
Our results indicate a satisfactory acceptance of BCT by patients who are young and have small tumors, node-negative disease, or surgery in private hospitals. However, the continuing unpopularity of breast screening is likely a major factor limiting the broad use of BCT.
Yau
Tsz-Kok
TK
Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Soong
Inda S
IS
Sze
Henry
H
Choi
Cheuk-Wai
CW
Yeung
Mei-Wan
MW
Ng
Wai-Tong
WT
Lee
Anne W M
AW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000033:anatomy & histology; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006723:Hong Kong; D006801:Humans; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental / Q000639:trends*; D008875:Middle Aged; D009367:Neoplasm Staging; D009929:Organ Size; D012189:Retrospective Studies; D055815:Young Adult