Trends in the surgical procedures of women with incident breast cancer in Catalonia, Spain, over a 7-year period (2005-2011)

被引:12
作者
Escribà J.M. [1 ]
Pareja L. [1 ]
Esteban L. [1 ]
Gálvez J. [1 ]
Melià A. [1 ]
Roca L. [1 ]
Clèries R. [1 ,2 ]
Sanz X. [1 ]
Bustins M. [3 ]
Pla M.J. [4 ]
Gil M.J. [4 ]
Borrás J.M. [1 ]
Ribes J. [1 ]
机构
[1] Catalonian Cancer Registry, Cancer Planning Direc., Av. Gran Vía 199-203, L'Hospitalet de Llobregat
[2] Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, L'Hospitalet de Llobregat
[3] Servei d' Informació i Estudis, Catalonian Health Service, Health Department, L'Hospitalet de Llobregat
[4] Breast Cancer Functional Unit, Institut Català d' Oncologia, L'Hospitalet de Llobregat
关键词
Breast cancer; Hospital discharge dataset; Incident cases; Surgical procedures;
D O I
10.1186/1756-0500-7-587
中图分类号
学科分类号
摘要
Background: Breast cancer (BC) is the most frequent cancer in women, accounting for 28% of all tumors among women in Catalonia (Spain). Mastectomy has been replaced over time by breast-conserving surgery (BCS) although not as rapidly as might be expected. The aim of this study was to assess the evolution of surgical procedures in incident BC cases in Catalonia between 2005 and 2011, and to analyze variations based on patient and hospital characteristics. Methods. We processed data from the Catalonian Health Service's Acute Hospital Discharge database (HDD) using ASEDAT software (Analysis, Selection and Extraction of Tumor Data) to identify all invasive BC incident cases according to the codes 174.0-174.9 of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) that were attended for the one-year periods in 2005, 2008 and 2011. Patients were classified according to surgical procedures (BCS vs mastectomy, and immediate vs delayed reconstruction), and results were compared among periods according to age, stage, comorbidity and hospital level. Results: BC surgical procedures were performed in more than 80% of patients. Surgical cases showed a significant increasing trend in the proportion of women aged 50-69 years, more advanced disease stages, higher comorbidity and they were attended in hospitals of less complexity level throughout the study period. Similar pattern was found for patients treated with BCS, which increased significantly from 67.9% in 2005 to 74.0% in 2011. Simple lymph node removal increased significantly (from 48.8% to 71.4% and from 63.6% to 67.8% for 2005 and 2011 in conservative and radical surgery, respectively). A slightly increase in the proportion of mastectomized young women (from 28% in 2005 to 34% in 2011) was detected, due to multiple factors. About 22% of women underwent post-mastectomy breast reconstruction, this being mostly immediate. Conclusions: The use of HDD linked to the ASEDAT allowed us to evaluate BC surgical treatment in Catalonia. A consolidating increasing trend of BCS was observed in women aged 50-69 years, which corresponds with the pattern in most European countries. Among the mastectomized patients, immediate breast reconstructions have risen significantly over the period 2005-2011. © 2014 Escribà et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 46 条
[1]  
Ferlay J., Shin H., Bray F., Forman D., Mathers C., Parkin D.M., Estimates of Worldwide burden of cancer in 2008: GLOBOCAN 2008, Int J Cancer, 127, pp. 2893-2917, (2010)
[2]  
Jemal A., Center M., Desantis C., Global patterns of cancer incidence and mortality rates and trends, Cancer Epidemiol Biomarkers Prev, 19, pp. 1893-1907, (2010)
[3]  
Ferlay J., Autier P., Boniol M., Heanue M., Colombet M., Boyle P., Estimates of the cancer incidence and mortality in Europe in 2006, Ann Oncol, 18, pp. 581-592, (2007)
[4]  
Pollan M., Michelena M.J., Ardanaz E., Izquierdo A., Sanchez Perez M.J., Torrella A., Breast cancer incidence in Spain before, during and after the implementation of screening programmes, Ann Oncol, 21, SUPPL. 3, pp. 97-102, (2010)
[5]  
Pollan M., Pastor-Barriuso R., Ardanaz E., Arguelles M.M.C., Galceran J., Recent changes in Breast Cancer Incidence in Spain, 1980-2004, J Natl Cancer Inst, 101, pp. 1584-1591, (2009)
[6]  
Sanchez M.J., Payer T., De Angelis R., Larranaga N., Capocaccia R., Martinez C., Cancer incidence and mortality in Spain: Estimates and projections for the period 1981-2012, Ann Oncol, 21, SUPPL. 3, pp. 30-36, (2010)
[7]  
Vidal C., Martinez-Sanchez J.M., Mateos M., Peris M., Mortalidad por cáncer de mama: Evolución en España y sus comunidades autónomas durante el periodo 1980-2005, Rev Esp Salud Publica, 84, pp. 53-59, (2010)
[8]  
De Cancer C., Estadistiques G., Data from the Population Cancer Registries of Girona and Tarragona, and Mortality Registry of Health Department, Analyzed by the Catalonian Cancer Planning Directorate
[9]  
Berrino F., De Angelis R., Sant M., Rosso S., Lasota M.B., Coebergh J.W., Santaquilani M., Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: Results of the EUROCARE-4 study, Lancet Oncol, 8, pp. 773-783, (2007)
[10]  
Guías de Práctica Clínica en Cáncer de Catalunya. OncoGuía de Mama. Actualización 2008, (2008)