Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States
Purpose For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM...
Gespeichert in:
| Veröffentlicht in: | Breast cancer research and treatment 2016-11, Vol.160 (1), p.111-120 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 120 |
|---|---|
| container_issue | 1 |
| container_start_page | 111 |
| container_title | Breast cancer research and treatment |
| container_volume | 160 |
| creator | Sisco, Mark Kyrillos, Alexandra M. Lapin, Brittany R. Wang, Chihsiung E. Yao, Katharine A. |
| description | Purpose
For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use.
Methods
Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (
n
= 114,849). Associations between patient, tumor, and facility characteristics and NSM were assessed using logistic regression.
Results
The rate of NSM increased from 2.9 to 8.0 % between 2010 and 2013. NSM was most commonly performed in academic (adjusted odds ratio [OR] 1.43,
p
|
| doi_str_mv | 10.1007/s10549-016-3975-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1835349654</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A470711590</galeid><sourcerecordid>A470711590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-bc4978e41b178a9dac63fda4599aaa1cd1be1c2051bdbb4e5dd933214f9f24a43</originalsourceid><addsrcrecordid>eNqNkk9rFTEUxYMotj79AG4kIIibqckkmUyWpfgPCi5s1yGT3OlLmUnGJFPotzfDa7UVBckicO_vHDjcg9BrSk4oIfJDpkRw1RDaNUxJ0agn6JgKyRrZUvkUHdeFbLqedEfoRc7XhBAliXqOjlrZtaTv2TGyFwmCy9gEh29M8qb4GLAPuOwBrxlwHHHwyzJBk5e6D1d4NrmALXG-xWNMeEhQB9iaYCHdKy-DL-Dw92IK5Jfo2WimDK_u_h26_PTx4uxLc_7t89ez0_PGCsJKM1iuZA-cDlT2RjljOzY6w4VSxhhqHR2A2pYIOrhh4CCcU4y1lI9qbLnhbIfeH3yXFH-skIuefbYwTSZAXLOmPROMq078D9rKXsmuSnbo7R_odVxTqEE2SvS0pV33m7oyE2gfxliSsZupPuWSSEqFIpU6-QtVn4PZ2xhg9HX-SPDugWAPZir7HKd1u1J-DNIDaFPMOcGol-Rnk241JXoriz6URddO6K0sWlXNm7tk6zCD-6W4b0cF2gOQl-3ykB5E_6frT6UNxy0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1825812166</pqid></control><display><type>article</type><title>Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sisco, Mark ; Kyrillos, Alexandra M. ; Lapin, Brittany R. ; Wang, Chihsiung E. ; Yao, Katharine A.</creator><creatorcontrib>Sisco, Mark ; Kyrillos, Alexandra M. ; Lapin, Brittany R. ; Wang, Chihsiung E. ; Yao, Katharine A.</creatorcontrib><description><![CDATA[Purpose
For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use.
Methods
Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (
n
= 114,849). Associations between patient, tumor, and facility characteristics and NSM were assessed using logistic regression.
Results
The rate of NSM increased from 2.9 to 8.0 % between 2010 and 2013. NSM was most commonly performed in academic (adjusted odds ratio [OR] 1.43,
p
< 0.001) and high-volume (OR 1.59,
p
< 0.001) breast centers. There was up to a 5.8-fold variation in its delivery between geographic census regions (
p
< 0.001). Of 1231 hospitals, only 491 (39.9 %) reported performing at least one NSM during the study period. Half of all NSMs were performed by the top 6 % (
n
= 30) of NSM-performing centers. NSM was associated with small tumor size (
p
< 0.001), lower tumor grades (
p
< 0.05), and negative nodal status (
p
< 0.001). However, half of NSM patients had at least one tumor characteristic that diverged from current (2016) NCCN recommendations for the procedure.
Conclusions
The use of therapeutic NSM is increasing dramatically in the United States, despite recommendations that the procedure be used with caution. As NSM becomes increasingly common, efforts are needed to monitor its long-term oncologic outcomes and to ensure equitable access to it.]]></description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1007/s10549-016-3975-9</identifier><identifier>PMID: 27620883</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Breast cancer ; Breast Neoplasms - diagnosis ; Breast Neoplasms - epidemiology ; Breast Neoplasms - surgery ; Breast reconstruction ; Cancer research ; Cancer therapies ; Clinical outcomes ; Databases, Factual ; Epidemiology ; Ethnic Groups ; Female ; Hospitals ; Humans ; Mammaplasty ; Mastectomy ; Mastectomy, Subcutaneous - statistics & numerical data ; Mastectomy, Subcutaneous - trends ; Medical research ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Patient Acceptance of Health Care - statistics & numerical data ; Population Surveillance ; Retrospective Studies ; Skin ; Socioeconomic Factors ; Statistical data ; United States - epidemiology ; Young Adult</subject><ispartof>Breast cancer research and treatment, 2016-11, Vol.160 (1), p.111-120</ispartof><rights>Springer Science+Business Media New York 2016</rights><rights>COPYRIGHT 2016 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-bc4978e41b178a9dac63fda4599aaa1cd1be1c2051bdbb4e5dd933214f9f24a43</citedby><cites>FETCH-LOGICAL-c503t-bc4978e41b178a9dac63fda4599aaa1cd1be1c2051bdbb4e5dd933214f9f24a43</cites><orcidid>0000-0003-1493-0164</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10549-016-3975-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10549-016-3975-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27620883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sisco, Mark</creatorcontrib><creatorcontrib>Kyrillos, Alexandra M.</creatorcontrib><creatorcontrib>Lapin, Brittany R.</creatorcontrib><creatorcontrib>Wang, Chihsiung E.</creatorcontrib><creatorcontrib>Yao, Katharine A.</creatorcontrib><title>Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><addtitle>Breast Cancer Res Treat</addtitle><description><![CDATA[Purpose
For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use.
Methods
Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (
n
= 114,849). Associations between patient, tumor, and facility characteristics and NSM were assessed using logistic regression.
Results
The rate of NSM increased from 2.9 to 8.0 % between 2010 and 2013. NSM was most commonly performed in academic (adjusted odds ratio [OR] 1.43,
p
< 0.001) and high-volume (OR 1.59,
p
< 0.001) breast centers. There was up to a 5.8-fold variation in its delivery between geographic census regions (
p
< 0.001). Of 1231 hospitals, only 491 (39.9 %) reported performing at least one NSM during the study period. Half of all NSMs were performed by the top 6 % (
n
= 30) of NSM-performing centers. NSM was associated with small tumor size (
p
< 0.001), lower tumor grades (
p
< 0.05), and negative nodal status (
p
< 0.001). However, half of NSM patients had at least one tumor characteristic that diverged from current (2016) NCCN recommendations for the procedure.
Conclusions
The use of therapeutic NSM is increasing dramatically in the United States, despite recommendations that the procedure be used with caution. As NSM becomes increasingly common, efforts are needed to monitor its long-term oncologic outcomes and to ensure equitable access to it.]]></description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnosis</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast reconstruction</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Clinical outcomes</subject><subject>Databases, Factual</subject><subject>Epidemiology</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Mammaplasty</subject><subject>Mastectomy</subject><subject>Mastectomy, Subcutaneous - statistics & numerical data</subject><subject>Mastectomy, Subcutaneous - trends</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Population Surveillance</subject><subject>Retrospective Studies</subject><subject>Skin</subject><subject>Socioeconomic Factors</subject><subject>Statistical data</subject><subject>United States - epidemiology</subject><subject>Young Adult</subject><issn>0167-6806</issn><issn>1573-7217</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkk9rFTEUxYMotj79AG4kIIibqckkmUyWpfgPCi5s1yGT3OlLmUnGJFPotzfDa7UVBckicO_vHDjcg9BrSk4oIfJDpkRw1RDaNUxJ0agn6JgKyRrZUvkUHdeFbLqedEfoRc7XhBAliXqOjlrZtaTv2TGyFwmCy9gEh29M8qb4GLAPuOwBrxlwHHHwyzJBk5e6D1d4NrmALXG-xWNMeEhQB9iaYCHdKy-DL-Dw92IK5Jfo2WimDK_u_h26_PTx4uxLc_7t89ez0_PGCsJKM1iuZA-cDlT2RjljOzY6w4VSxhhqHR2A2pYIOrhh4CCcU4y1lI9qbLnhbIfeH3yXFH-skIuefbYwTSZAXLOmPROMq078D9rKXsmuSnbo7R_odVxTqEE2SvS0pV33m7oyE2gfxliSsZupPuWSSEqFIpU6-QtVn4PZ2xhg9HX-SPDugWAPZir7HKd1u1J-DNIDaFPMOcGol-Rnk241JXoriz6URddO6K0sWlXNm7tk6zCD-6W4b0cF2gOQl-3ykB5E_6frT6UNxy0</recordid><startdate>20161101</startdate><enddate>20161101</enddate><creator>Sisco, Mark</creator><creator>Kyrillos, Alexandra M.</creator><creator>Lapin, Brittany R.</creator><creator>Wang, Chihsiung E.</creator><creator>Yao, Katharine A.</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1493-0164</orcidid></search><sort><creationdate>20161101</creationdate><title>Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States</title><author>Sisco, Mark ; Kyrillos, Alexandra M. ; Lapin, Brittany R. ; Wang, Chihsiung E. ; Yao, Katharine A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-bc4978e41b178a9dac63fda4599aaa1cd1be1c2051bdbb4e5dd933214f9f24a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnosis</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast reconstruction</topic><topic>Cancer research</topic><topic>Cancer therapies</topic><topic>Clinical outcomes</topic><topic>Databases, Factual</topic><topic>Epidemiology</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Mammaplasty</topic><topic>Mastectomy</topic><topic>Mastectomy, Subcutaneous - statistics & numerical data</topic><topic>Mastectomy, Subcutaneous - trends</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Population Surveillance</topic><topic>Retrospective Studies</topic><topic>Skin</topic><topic>Socioeconomic Factors</topic><topic>Statistical data</topic><topic>United States - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sisco, Mark</creatorcontrib><creatorcontrib>Kyrillos, Alexandra M.</creatorcontrib><creatorcontrib>Lapin, Brittany R.</creatorcontrib><creatorcontrib>Wang, Chihsiung E.</creatorcontrib><creatorcontrib>Yao, Katharine A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Breast cancer research and treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sisco, Mark</au><au>Kyrillos, Alexandra M.</au><au>Lapin, Brittany R.</au><au>Wang, Chihsiung E.</au><au>Yao, Katharine A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States</atitle><jtitle>Breast cancer research and treatment</jtitle><stitle>Breast Cancer Res Treat</stitle><addtitle>Breast Cancer Res Treat</addtitle><date>2016-11-01</date><risdate>2016</risdate><volume>160</volume><issue>1</issue><spage>111</spage><epage>120</epage><pages>111-120</pages><issn>0167-6806</issn><eissn>1573-7217</eissn><coden>BCTRD6</coden><abstract><![CDATA[Purpose
For many women, nipple-sparing mastectomy (NSM) provides aesthetic and quality-of-life outcomes superior to skin-sparing mastectomy. Accumulating data suggest that NSM provides similar oncologic outcomes in select breast cancer patients. This study sought to determine national trends in NSM use.
Methods
Using the National Cancer Data Base, 6254 women with breast cancer who underwent NSM between 2010 and 2013 were identified. NSM rates were determined relative to the number of patients who received a mastectomy with reconstruction (
n
= 114,849). Associations between patient, tumor, and facility characteristics and NSM were assessed using logistic regression.
Results
The rate of NSM increased from 2.9 to 8.0 % between 2010 and 2013. NSM was most commonly performed in academic (adjusted odds ratio [OR] 1.43,
p
< 0.001) and high-volume (OR 1.59,
p
< 0.001) breast centers. There was up to a 5.8-fold variation in its delivery between geographic census regions (
p
< 0.001). Of 1231 hospitals, only 491 (39.9 %) reported performing at least one NSM during the study period. Half of all NSMs were performed by the top 6 % (
n
= 30) of NSM-performing centers. NSM was associated with small tumor size (
p
< 0.001), lower tumor grades (
p
< 0.05), and negative nodal status (
p
< 0.001). However, half of NSM patients had at least one tumor characteristic that diverged from current (2016) NCCN recommendations for the procedure.
Conclusions
The use of therapeutic NSM is increasing dramatically in the United States, despite recommendations that the procedure be used with caution. As NSM becomes increasingly common, efforts are needed to monitor its long-term oncologic outcomes and to ensure equitable access to it.]]></abstract><cop>New York</cop><pub>Springer US</pub><pmid>27620883</pmid><doi>10.1007/s10549-016-3975-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-1493-0164</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-6806 |
| ispartof | Breast cancer research and treatment, 2016-11, Vol.160 (1), p.111-120 |
| issn | 0167-6806 1573-7217 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1835349654 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adult Aged Aged, 80 and over Breast cancer Breast Neoplasms - diagnosis Breast Neoplasms - epidemiology Breast Neoplasms - surgery Breast reconstruction Cancer research Cancer therapies Clinical outcomes Databases, Factual Epidemiology Ethnic Groups Female Hospitals Humans Mammaplasty Mastectomy Mastectomy, Subcutaneous - statistics & numerical data Mastectomy, Subcutaneous - trends Medical research Medicine Medicine & Public Health Middle Aged Oncology Patient Acceptance of Health Care - statistics & numerical data Population Surveillance Retrospective Studies Skin Socioeconomic Factors Statistical data United States - epidemiology Young Adult |
| title | Trends and variation in the use of nipple-sparing mastectomy for breast cancer in the United States |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T23%3A33%3A41IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Trends%20and%20variation%20in%20the%20use%20of%20nipple-sparing%20mastectomy%20for%20breast%20cancer%20in%20the%20United%20States&rft.jtitle=Breast%20cancer%20research%20and%20treatment&rft.au=Sisco,%20Mark&rft.date=2016-11-01&rft.volume=160&rft.issue=1&rft.spage=111&rft.epage=120&rft.pages=111-120&rft.issn=0167-6806&rft.eissn=1573-7217&rft.coden=BCTRD6&rft_id=info:doi/10.1007/s10549-016-3975-9&rft_dat=%3Cgale_proqu%3EA470711590%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1825812166&rft_id=info:pmid/27620883&rft_galeid=A470711590&rfr_iscdi=true |