Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Factors predictive of treatment by Australian breast surgeons of invasive female breast cancer by mastectomy rather than breast conserving surgery
Author: Roder, D.
Zorbas, H.
Kollias, J.
Pyke, C.
Walters, D.
Campbell, I.
Taylor, C.
Webster, F.
Citation: Asian Pacific Journal of Cancer Prevention (APJCP), 2013; 14(1):539-545
Publisher: Asian Pacific Organization for Cancer Prevention
Issue Date: 2013
ISSN: 1513-7368
Statement of
David Roder, Helen Zorbas, James Kollias, Chris Pyke, David Walters, Ian Campbell, Corey Taylor, Fleur Webster
Abstract: Background: The National Breast Cancer Audit Database of the Society of Breast Surgeons of Australia and New Zealand is used by surgeons to monitor treatment quality and for research. About 60% of early invasive female breast cancers in Australia are recorded. The objectives of this study are: (1) to investigate associations of socio-demographic, health-system and clinical characteristics with treatment of invasive female breast cancer by mastectomy compared with breast conserving surgery; and (2) to consider service delivery implications. Materials and Methods: Bi-variable and multivariable analyses of associations of characteristics with surgery type for cancers diagnosed in 1998-2010. Results: Of 30,299 invasive cases analysed, 11,729 (39%) were treated by mastectomy as opposed to breast conserving surgery. This proportion did not vary by diagnostic year (p>0.200). With major city residence as the reference category, the relative rate (95% confidencelimits) of mastectomy was 1.03 (0.99, 1.07) for women from inner regional areas and 1.05 (1.01, 1.10) for those from more remote areas. Low annual surgeon case load (≤10) was predictive of mastectomy, with a relative rate of 1.08 (1.03, 1.14) when compared with higher case loads. Tumour size was also predictive, with a relative rate of 1.05 (1.01, 1.10) for large cancers (40+ mm) compared with smaller cancers (<30 mm). These associations were confirmedin multiple logistic regression analysis. Conclusions: Results confirmprevious studies showing higher mastectomy rates for residents of more remote areas, those treated by surgeons with low case loads, and those with large cancers. Reasons require further study, including possible effects of surgeon and woman’s choice and access to radiotherapy services.
Keywords: Mastectomy
clinical determinants
Rights: Copyright Author/s.All APJCP content is Open Access, meaning it is accessible online to everyone, without fee or the authors' permission. Papers are published and distributed under the terms of the Creative Commons Attribution License ( licenses/by/3.0/), under which authors reserve the copyright for their content; however, they permit anyone unrestricted non-commercial use as long as the original authors and source are cited.
DOI: 10.7314/APJCP.2013.14.1.539
Published version:
Appears in Collections:Aurora harvest
Public Health publications

Files in This Item:
File Description SizeFormat 
hdl_82282.pdfPublished version379.22 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.