Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008)
CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian...
| Autores: | , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2012 |
| País: | Brasil |
| Institución: | Associação Paulista de Medicina |
| Repositorio: | São Paulo medical journal (Online) |
| Idioma: | inglés |
| OAI Identifier: | oai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1527 |
| Acceso en línea: | https://periodicosapm.emnuvens.com.br/spmj/article/view/1527 |
| Access Level: | acceso abierto |
| Palabra clave: | Mastectomia Mastectomia segmentar Neoplasias da mama Brasil Estadiamento de neoplasias Mastectomy Mastectomy, segmental Breast neoplasms Brazil Neoplasm staging |
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Brasil |
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| dc.title.none.fl_str_mv |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) Mudanças nas taxas de mastectomia em um hospital público brasileiro ao longo de 20 anos (1989 a 2008) |
| title |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| spellingShingle |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) Balabram, Débora Mastectomia Mastectomia segmentar Neoplasias da mama Brasil Estadiamento de neoplasias Mastectomy Mastectomy, segmental Breast neoplasms Brazil Neoplasm staging |
| title_short |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| title_full |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| title_fullStr |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| title_full_unstemmed |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| title_sort |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008) |
| dc.creator.none.fl_str_mv |
Balabram, Débora Araújo, Fábio Braga Porto, Simone Souza Rodrigues, Joyce Soares Sousa, Atila Silva Siqueira, Arminda Lucia Gobbi, Helenice |
| author |
Balabram, Débora |
| author_facet |
Balabram, Débora Araújo, Fábio Braga Porto, Simone Souza Rodrigues, Joyce Soares Sousa, Atila Silva Siqueira, Arminda Lucia Gobbi, Helenice |
| author_role |
author |
| author2 |
Araújo, Fábio Braga Porto, Simone Souza Rodrigues, Joyce Soares Sousa, Atila Silva Siqueira, Arminda Lucia Gobbi, Helenice |
| author2_role |
author author author author author author |
| dc.subject.por.fl_str_mv |
Mastectomia Mastectomia segmentar Neoplasias da mama Brasil Estadiamento de neoplasias Mastectomy Mastectomy, segmental Breast neoplasms Brazil Neoplasm staging |
| topic |
Mastectomia Mastectomia segmentar Neoplasias da mama Brasil Estadiamento de neoplasias Mastectomy Mastectomy, segmental Breast neoplasms Brazil Neoplasm staging |
| description |
CONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients’ age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease. |
| publishDate |
2012 |
| dc.date.none.fl_str_mv |
2012-11-11 |
| dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.uri.fl_str_mv |
https://periodicosapm.emnuvens.com.br/spmj/article/view/1527 |
| url |
https://periodicosapm.emnuvens.com.br/spmj/article/view/1527 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
https://periodicosapm.emnuvens.com.br/spmj/article/view/1527/1428 |
| dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0 |
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openAccess |
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application/pdf |
| dc.publisher.none.fl_str_mv |
São Paulo Medical Journal São Paulo Medical Journal |
| publisher.none.fl_str_mv |
São Paulo Medical Journal São Paulo Medical Journal |
| dc.source.none.fl_str_mv |
São Paulo Medical Journal; Vol. 130 No. 6 (2012); 360-366 São Paulo Medical Journal; v. 130 n. 6 (2012); 360-366 1806-9460 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
| instname_str |
Associação Paulista de Medicina |
| instacron_str |
APM |
| institution |
APM |
| reponame_str |
São Paulo medical journal (Online) |
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São Paulo medical journal (Online) |
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São Paulo medical journal (Online) - Associação Paulista de Medicina |
| repository.mail.fl_str_mv |
revistas@apm.org.br |
| _version_ |
1853676241984421888 |
| spelling |
Changes in mastectomy rates at a Brazilian public hospital over 20 years (1989 to 2008)Mudanças nas taxas de mastectomia em um hospital público brasileiro ao longo de 20 anos (1989 a 2008)MastectomiaMastectomia segmentarNeoplasias da mamaBrasilEstadiamento de neoplasiasMastectomyMastectomy, segmentalBreast neoplasmsBrazilNeoplasm stagingCONTEXT AND OBJECTIVE: Recently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts. DESIGN AND SETTING: A retrospective study in a Brazilian public hospital. METHODS: Pathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis. RESULTS: From 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients’ age greater than 68 years (P = 0.007) were predictors of mastectomy. CONCLUSIONS: There was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.CONTEXTO E OBJETIVO: Recentemente, a cirurgia conservadora tem substituído a mastectomia para tratamento cirúrgico do câncer de mama. O objetivo deste estudo é avaliar as mudanças nas taxas de mastectomia e cirurgia conservadora e os fatores relacionados a essas mudanças. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo em hospital público brasileiro. MÉTODOS: Dados patológicos das pacientes submetidas a cirurgia para câncer de mama no Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), de 1989 a 2008, foram revistos. As taxas de mastectomia e cirurgia conservadora foram calculadas. O teste qui-quadrado foi usado para avaliar fatores relacionados ao tipo de tratamento cirúrgico empregado e comparar tendências de tipo de tratamento ao longo dos anos. Regressão logística foi usada para análise multivariada. RESULTADOS: De 1989 a 2008, 2.050 espécimes cirúrgicos de câncer de mama foram recebidos em nosso serviço, correspondentes a 1.973 pacientes; 1.324 (64,6%) correspondentes a mastectomia e 726 (35,4%) correspondentes a cirurgia conservadora. A cirurgia conservadora se tornou mais frequente ao longo dos anos (P < 0,001). Em análise multivariada, ano mais precoce da cirurgia (P < 0,001), maior tamanho tumoral (P < 0,001), ter ao menos um linfonodo axilar positivo (P < 0,001) e idade maior de 68 anos (P = 0,007) foram preditores de mastectomia. CONCLUSÕES: As cirurgias conservadoras se tornaram mais frequentes em relação às mastectomias ao longo dos anos. Isso pode refletir a consolidação da cirurgia conservadora (associada a radioterapia) como equivalente à mastectomia em termos de sobrevida, bem como diagnóstico mais precoce da doença.São Paulo Medical JournalSão Paulo Medical Journal2012-11-11info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://periodicosapm.emnuvens.com.br/spmj/article/view/1527São Paulo Medical Journal; Vol. 130 No. 6 (2012); 360-366São Paulo Medical Journal; v. 130 n. 6 (2012); 360-3661806-9460reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APMenghttps://periodicosapm.emnuvens.com.br/spmj/article/view/1527/1428https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessBalabram, DéboraAraújo, Fábio BragaPorto, Simone SouzaRodrigues, Joyce SoaresSousa, Atila SilvaSiqueira, Arminda LuciaGobbi, Helenice2023-09-03T21:15:49Zoai:ojs.diagnosticoetratamento.emnuvens.com.br:article/1527Revistahttp://www.scielo.br/spmjPUBhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2023-09-03T21:15:49São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
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15,228081 |