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Related Experiment Videos

Subsequent surgery after initial breast conserving surgery: a population based study.

Katrina Spilsbury1, James B Semmens, Christobel M Saunders

  • 1Western Australian Safety and Quality of Surgical Care Project, Centre for Health Services Research, School of Population Health, University of Western Australia, Western Australia, Australia. skatrina@dph.uwa.edu.au

ANZ Journal of Surgery
|June 4, 2005
PubMed
Summary

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Younger women and those treated in non-metropolitan hospitals face higher risks of repeat breast cancer surgery. Improving rural healthcare access is crucial for equitable breast cancer management.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Public Health

Background:

  • Increasing adoption of breast conserving surgery (BCS) for early breast cancer in Australia.
  • A subset of women require further surgery due to involved margins, relapse, or patient preference.
  • Need to identify factors influencing re-excision or mastectomy risk after BCS.

Purpose of the Study:

  • To investigate socio-economic, demographic, and hospital-associated factors for re-excision or mastectomy risk post-BCS.
  • To analyze trends in BCS and subsequent surgeries over time.
  • To inform strategies for improving breast cancer treatment outcomes.

Main Methods:

  • Population-based record linkage study of 12,711 women diagnosed with breast cancer in Western Australia (1982-2000).

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  • Inclusion criteria: diagnosis within the study period and breast surgery within 12 months.
  • Logistic regression analysis to identify risk factors for further surgery.

    • Main Results:

    • Proportion of initial BCS increased from 33% (1982-1985) to 72% (1998-2000).
    • Rate of further surgery post-BCS decreased from 50% to 30% during the study period.
    • Higher risk of re-excision/mastectomy in non-metropolitan hospitals (2.4-5.0 times) and for younger women (1.7-2.1 times).

    Conclusions:

    • Younger women and those treated in non-metropolitan hospitals have a significantly increased risk of re-excision or mastectomy.
    • Urgent need to enhance specialist healthcare services in rural areas to mitigate these disparities.
    • Findings highlight the importance of equitable access to high-quality breast cancer care across different geographic locations.