title: Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database.
abstract: BACKGROUND
  Recent single-institution reports have shown increased mastectomy rates during the last decade. Further studies aiming to determine if these reports could be reflecting a national trend in the United States of America (US) have shown conflicting results. We report these trends from a multi-institutional European database.
  
  
  METHODS
  Our source of data was the eusomaDB, a central data warehouse of prospectively collected information of the European Society of Breast Cancer Specialists (EUSOMA). We identified patients with newly diagnosed unilateral early-stage breast cancer (stages 0, I or II) to examine rates and trends in surgical treatment.
  
  
  RESULTS
  A total of 15,369 early-stage breast cancer cases underwent surgery in 13 Breast Units from 2003 to 2010. Breast conservation was successful in 11,263 cases (73.3%). Adjusted trend by year showed a statistically significant decrease in mastectomy rates from 2005 to 2010 (p = 0.003) with a progressive reduction of 4.24% per year. A multivariate model showed a statistically significant association of the following factors with mastectomy: age < 40 or ≥ 70 years, pTis, pT1mi, positive axillary nodes, lobular histology, tumour grade II and III, negative progesterone receptors and multiple lesions.
  
  
  CONCLUSIONS
  Our study demonstrates that a high proportion of patients with newly diagnosed unilateral early-stage breast cancer from the eusomaDB underwent breast-conserving surgery. It also shows a significant trend of decreasing mastectomy rates from 2005 to 2010. Moreover, our study suggests mastectomy rates in the population from the eusomaDB are lower than those reported in the US.
authors.affiliation: Breast Unit, Humanitas Cancer Center, Milan, Rozzano, Italy; EUSOMA Data Centre, Turin, Italy.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Garcia-Etienne
authors.forename: Mariano
authors.initials: M
authors.lastname: Tomatis
authors.forename: Joerg
authors.initials: J
authors.lastname: Heil
authors.forename: Kay
authors.initials: K
authors.lastname: Friedrichs
authors.forename: Rolf
authors.initials: R
authors.lastname: Kreienberg
authors.forename: Andreas
authors.initials: A
authors.lastname: Denk
authors.forename: Marion
authors.initials: M
authors.lastname: Kiechle
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Lorenz-Salehi
authors.forename: Rainer
authors.initials: R
authors.lastname: Kimmig
authors.forename: Günter
authors.initials: G
authors.lastname: Emons
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Danaei
authors.forename: Volker
authors.initials: V
authors.lastname: Heyl
authors.forename: Uwe
authors.initials: U
authors.lastname: Heindrichs
authors.forename: Christoph J
authors.initials: CJ
authors.lastname: Rageth
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
authors.forename: Lorenza
authors.initials: L
authors.lastname: Marotti
authors.forename: Marco Rosselli
authors.initials: MR
authors.lastname: del Turco
authors.forename: Antonio
authors.initials: A
authors.lastname: Ponti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016208:Databases, Factual; D005060:Europe; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000379:methods / Q000639:trends*; D015412:Mastectomy, Segmental / Q000639:trends*; D008875:Middle Aged; D015996:Survival Rate; D055815:Young Adult