Factors predicting receipt of contralateral prophylactic mastectomy for women diagnosed with early stage invasive breast cancer in the United States, 2004-2010 Pubblico

Abstract

Objective: The use of contralateral prophylactic mastectomy (CPM) for early stage breast cancers has been increasing over the last decade. Although CPM does not provide increased survival, many women are beginning to choose this therapy over the recommended surgeries, unilateral total mastectomy (UTM) and breast conserving surgery (BCS). Trends and predictors of CPM have been researched before 2004, but not for the most recent years.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) research-access dataset from 2004 through 2010, predictors of receipt of CPM were compared across three age groups. Multivariate logistic regression models were used to determine associations between patient and diagnostic characteristics and receipt of CPM, across the three age groups.

Results: For women of all ages, the odds of electing CPM over UTM/BCS in 2010 were over 2.5 times the odds of electing CPM in 2004. Women of all ages living in the Midwest, as well as women under 64 in the South and women under 49 in the Northeast, were more likely to elect CPM over UTM/BCS than women living in the West at their time of diagnosis. Women between 60 and 79 in the Northeast were less likely to elect CPM over UTM/BCS than their counterparts in the Western region of the US. White women and married women were the most likely to undergo CPM. In addition, women under the age of 64 living in metropolitan areas were more likely to elect CPM compared to women living in urban areas. Across all age groups, women with increased nodal involvement, larger tumor size, and lobular histologic type were the most likely to elect CPM over the alternative surgeries.

Conclusion: Women with early stage unilateral breast cancer are increasingly electing CPM over UTM and BCS from year to year. Future studies will be able to use this data, along with previous data, to address this growing trend and evaluate the processes in which physicians discuss therapy options with early stage breast cancer patients.

Table of Contents

Background and Literature Review 1
Methods 6
Data Source 6
Study Subjects 6
Analysis 8
Results 12
Discussion 16
Conclusion 18
References 19
Tables 21
Table 1 21
Table 2 22
Table 3 23
Table 4 24
Table 5 25

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Parola chiave	mastectomy SEER women BCS risk factors Breast cancer early stage predictors CPM cancer breast conserving surgery treatment lumpectomy surgery UTM epidemiology total mastectomy contralateral prophylactic mastectomy
Committee Chair / Thesis Advisor	Ward, Kevin C., Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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