title: Surgical options for Chinese patients with early invasive breast cancer: Data from the Hong Kong Breast Cancer Registry.
abstract: BACKGROUND
  Breast conserving surgery (BCS) is preferred for suitable candidates, while mastectomy (MTX) with reconstruction (MTX + R) is considered a better option for patients requiring MTX. In Hong Kong, the rates of BCS and breast reconstruction are relatively low. This paper aims to study the surgical options and their predictors among Hong Kong breast cancer patients.
  
  
  METHODS
  Data is retrieved from the Hong Kong Breast Cancer Registry (HKBCR) from 2007 to 2013. A total of 4519 Stage I-II breast cancer patients who had surgical treatments were included in this retrospective study.
  
  
  RESULTS
  Our multivariate logistic regression shows that people who were younger (age < 40 years: OR, 1.5; 95% CI, 1.1-2.1; p = 0.010), more educated (undergraduate/postgraduate: OR, 2.8; 95% CI, 1.7-4.4; p < 0.0001), never married (OR, 1.5; 95% CI, 1.1-1.9; p = 0.002), had regular mammography screening (OR, 1.5; 95% CI, 1.3-1.8; p < 0.0001), had screen-detected cancers (OR, 1.3; 95% CI, 1.0-1.6; p = 0.031), and who underwent surgery at a private medical service facility (OR, 1.8; 95% CI, 1.6-2.2; p < 0.0001) were more likely to receive BCS. In addition, people who were younger (age < 40 years: OR, 15.9; 95% CI, 6.5-39.2; p < 0.0001), more educated (undergraduate/postgraduate: OR, 26.8; 95% CI, 3.6-201.4; p = 0.001), had regular mammography screening (OR, 1.6; 95% CI, 1.1-2.3; p = 0.008), had screen-detected cancers (OR, 2.1; 95% CI, 1.4-3.3; p = 0.001), and had smaller tumor (≤ 2.0 cm: OR, 0.39; 95% CI, 0.20-0.76; p = 0.005) were more likely to have reconstruction after MTX.
  
  
  CONCLUSIONS
  Chinese patients have lower BCS and breast reconstruction rate. Besides cultural difference, patient-related factors such as age, education, marital status, mammography screening, the use of private medical facilities, and clinical characteristics including smaller tumor size and peripherally located tumor were significant predictors for type of surgical treatments in Chinese women with early breast cancer.
authors.affiliation: Kowloon East Cluster Breast Centre, Department of Surgery, United Christian Hospital, Hong Kong, China. Electronic address: research@hkbcf.org.
authors.forename: Sharon W W
authors.initials: SWW
authors.lastname: Chan
authors.affiliation: Hong Kong Breast Cancer Foundation, Hong Kong, China.
authors.forename: Catherine
authors.initials: C
authors.lastname: Cheung
authors.affiliation: Hong Kong Breast Cancer Foundation, Hong Kong, China.
authors.forename: Amy
authors.initials: A
authors.lastname: Chan
authors.affiliation: Hong Kong Breast Cancer Foundation, Hong Kong, China.
authors.forename: Polly S Y
authors.initials: PSY
authors.lastname: Cheung
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data; D001943:Breast Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D018572:Disease-Free Survival; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006723:Hong Kong; D006801:Humans; D016015:Logistic Models; D016462:Mammaplasty / Q000706:statistics & numerical data; D008408:Mastectomy / Q000379:methods* / Q000401:mortality; D015412:Mastectomy, Segmental / Q000379:methods / Q000401:mortality; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: breast; breast conserving surgery; carcinoma; invasive ductal; mastectomy