title: Breast cancer mastectomy trends between 2006 and 2010: association with magnetic resonance imaging, immediate breast reconstruction, and hospital volume.
abstract: OBJECTIVE
  Analysis of mastectomy rates in breast cancer patients diagnosed between 2006 and 2010 in Germany with focus on impact of breast magnetic resonance imaging (MRI), immediate breast reconstruction (IBR) rates, and hospital volume as possible influencing factors of mastectomy rates.
  
  
  METHODS
  Data of a voluntary monitored benchmarking project were used to evaluate mastectomy trends across time in an unselected cohort of breast cancer patients. We used univariate and multivariate logistic regression analysis to identify predictive factors of mastectomy.
  
  
  RESULTS
  A total of 142.863 cases were included into the analysis. There was an overall decrease of 5.9% (95% confidence interval 5.1-6.7) in mastectomy trend from 36.5% in 2006 to 30.6% in 2010 (P < 0.0001). Known predictive factors were confirmed. Breast MRI (odds ratio 1.42, 95% confidence interval 1.36-1.47) and small hospitals (<150 cases per year) seem to favor mastectomy. IBR was not associated with mastectomy rates.
  
  
  CONCLUSIONS
  Mastectomy rates in comparable health systems differ. Performance of preoperative breast MRI and hospital volume seem to be independent influencing factors for mastectomy rates.
authors.affiliation: Breast Unit, University Hospital, University of Heidelberg, Heidelberg, Germany, joerg.heil@med.uni-heidelberg.de.
authors.forename: Joerg
authors.initials: J
authors.lastname: Heil
authors.forename: Geraldine
authors.initials: G
authors.lastname: Rauch
authors.forename: Akos Z
authors.initials: AZ
authors.lastname: Szabo
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Garcia-Etienne
authors.forename: Michael
authors.initials: M
authors.lastname: Golatta
authors.forename: Christoph
authors.initials: C
authors.lastname: Domschke
authors.forename: Mahyar
authors.initials: M
authors.lastname: Badiian
authors.forename: Peter
authors.initials: P
authors.lastname: Kern
authors.forename: Florian
authors.initials: F
authors.lastname: Schuetz
authors.forename: Markus
authors.initials: M
authors.lastname: Wallwiener
authors.forename: Christof
authors.initials: C
authors.lastname: Sohn
authors.forename: Hubertus
authors.initials: H
authors.lastname: Fries
authors.forename: Gunter
authors.initials: G
authors.lastname: von Minckwitz
authors.forename: Andreas
authors.initials: A
authors.lastname: Schneeweiss
authors.forename: Mahdi
authors.initials: M
authors.lastname: Rezai
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018275:Carcinoma, Lobular / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data*; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging; D016462:Mammaplasty; D008408:Mastectomy / Q000639:trends*; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases