Trends in surgical treatment of early-stage breast cancer reveal decreasing mastectomy use between 2003 and 2016 by age, race, and rurality

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Creator
  • Roberson, M.L.
    • Other Affiliation: Vanderbilt University
  • Nichols, H.B.
    • Gillings School of Global Public Health, Department of Epidemiology
  • Olshan, A.F.
    • Gillings School of Global Public Health, Department of Epidemiology
  • Wheeler, S.B.
    • School of Medicine, Department of Medicine
  • Reeder-Hayes, K.E.
    • School of Medicine, Department of Medicine
  • Robinson, W.R.
    • School of Medicine, Department of Pathology and Laboratory Medicine
Abstract
  • Purpose: To examine trends in the surgical treatment of breast cancer by age, rurality, and among Black women in a populous, racially diverse, state in the Southeastern United States of America. Methods: We identified women diagnosed with localized or regional breast cancer between 2003 and 2016 in the North Carolina Central Cancer Registry (n = 86,776). Using Joinpoint regression we evaluated the average annual percentage change in proportion of women treated with mastectomy versus breast-conserving surgery overall, by age group, among Black women, and for women residing in rural areas. Results: Overall, the rate of mastectomy usage in the population declined 2.5% per year between 2003 and 2016 (95% CI − 3.2, − 1.7). Over this same time interval, breast-conserving surgery increased by 1.6% per year (95% CI 0.9, 2.2). These temporal trends in surgery were also observed among Black women and rural residing women. Trends in surgery type varied by age group: mastectomy declined over time among women > 50 years, but not among women aged 18–49 at diagnosis. Discussion: In contrast to national studies that reported increasing use of mastectomy, we found declining mastectomy rates in the early 2000s in a Southern US state with a racially and geographically diverse population. These decreasing trends were consistent among key subgroups affected by cancer inequities, including Black and White rural women.
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Resource type
  • Article
Rights statement
  • In Copyright
Journal title
  • Breast Cancer Research and Treatment
Journal volume
  • 193
Journal issue
  • 2
Page start
  • 445
Page end
  • 454
Language
  • English
Funder
  • University of North Carolina, UNC
  • Robert Wood Johnson Foundation, RWJF
  • Agency for Healthcare Research and Quality, AHRQ: R36HS027299
ISSN
  • 0167-6806
Publisher
  • Springer

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