title: Trends in Radical Surgical Treatment Methods for Breast Malignancies in China: A Multicenter 10-Year Retrospective Study.
abstract: BACKGROUND
  Incidence rates of breast cancer continue to rise in the People's Republic of China. The purpose of this study was to describe Chinese trends in radical surgical modalities and influential imaging and demographic factors for breast malignancies.
  
  
  METHODS
  This study was a hospital-based, multicenter, 10-year (1999-2008), retrospective study. Descriptive statistical tests were used to illustrate information regarding radical surgical trends for the treatment of breast malignancies. Chi-square tests were used to assess effect of demographic factors in addition to imaging and pathological data on the specific surgical method.
  
  
  RESULTS
  A total of 4,211 patients were enrolled in the survey. Among them, 3,335 patients with stage 0 to stage III disease undergoing mastectomy or breast-conserving surgery (BCS) were included in the final analysis. The rate of BCS increased from 1.53% in 1999 to 11.88% in 2008. The rate of mastectomy declined over this time period, from 98.47% in 1999 to 88.12% in 2008, with increasing use of diagnostic imaging methods and pathological biopsies. A significantly greater percentage of patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy.
  
  
  CONCLUSIONS
  Rates of mastectomy in China remain elevated due to diagnosis at higher stages; however, because of increased use of diagnostic imaging, improvement of biopsy methods, and patient education, rates of less invasive lumpectomy are increasing and rates of mastectomy have decreased in China.
  
  
  CONCLUSIONS
  In this study, 4,211 cases were collected from 1999 to 2008 through a multicenter retrospective study of varying geographic and socioeconomic areas to illustrate trends of surgeries in the People's Republic of China. The correlations between demographic and tumor characteristics and among methods of surgical treatment were explored. This study shows that the rate of breast-conserving surgery (BCS) increased and the rate of mastectomy declined over this time period with increasing use of diagnostic imaging methods and pathological biopsies. Patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy in China.
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Bai-Lin
authors.initials: BL
authors.lastname: Zhang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Priya G
authors.initials: PG
authors.lastname: Sivasubramaniam
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Ji-Dong
authors.initials: JD
authors.lastname: Gao
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Zhong-Hua
authors.initials: ZH
authors.lastname: Tang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Guo-Ji
authors.initials: GJ
authors.lastname: Chen
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Xie
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Zhongzhao
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Hong-Jian
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: He
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Li
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Jin-Hu
authors.initials: JH
authors.lastname: Fan
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China xiangw@vip.sina.com qiaoy@cicams.ac.cn.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Departments of Breast Surgery and Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union of Medical College, Beijing, People's Republic of China; Fogarty Global Health Fellowship and Medical Scholars Research Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Department of Breast Surgery, Liaoning Cancer Hospital, Shenyang, People's Republic of China; Department of Breast-Thyroid Surgery, Second Xiangya Hospital, Central South University, Changsha, People's Republic of China; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Gungzhou, People's Republic of China; Department of Breast Surgery, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China; Department of Oncosurgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, People's Republic of China; Department of Breast Surgery, Sichuan Cancer Hospital, Chengdu, People's Republic of China; Department of Epidemiology, West China School of Public Health, Sichuan University, Chengdu, Sichuan, People's Republic of China xiangw@vip.sina.com qiaoy@cicams.ac.cn.
authors.forename: You-Lin
authors.initials: YL
authors.lastname: Qiao
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002681:China; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000379:methods* / Q000639:trends; D015412:Mastectomy, Segmental / Q000379:methods / Q000639:trends; D012189:Retrospective Studies
keywords: Breast neoplasms; Diagnosis; Imaging; Surgical