Abstract
Worldwide, breast conservation has become increasingly accepted as the surgical management of breast cancer in clinical practice. Cancer care in India is also evolving tremendously with many cancer treatment centres following evidence-based practice hence the rates of breast conservation are expected to increase. Here, we are reporting the rate of breast-conserving surgery (BCS) at our centre. A retrospective study of 401 patients who underwent breast cancer surgery at a tertiary care centre in South India from January 2015 to August 2017 were analysed to study the rate of BCS. All early breast cancers (EBC) were offered BCS. For large operable breast cancer (LOBC) and locally advanced breast cancer (LABC), neoadjuvant chemotherapy (NACT) followed by BCS was offered to these patients who wish to conserve their breast. The mean age was 45 years. A total of 163 patients underwent BCS. Yearly, BCS rates were 38.8% in 2015, 36.7% in 2016 and 46.5% in 2017. Majority had EBC 310 (77.3%) of which 62.7% of T1 lesions (n = 51) had BCS, and 45.7% of T2 lesions (n = 258) had BCS of which 5 patients had to undergo NACT to preserve their breast whereas 100% Tis patient (n = 1) had mastectomy. Fifty patients had LOBC and only 2 (4%) patients had upfront BCS whereas 9 of them had to undergo NACT (18%). cT4 lesions had NACT followed by BCS in 2 patients. The rates of BCS have been increasing in India over the past few years. The majority of the women presented with EBC which makes them suitable for BCS.
Similar content being viewed by others
References
Asthana S, Chauhan S, Labani S (2014) Breast and cervical cancer risk in India: an update. Indian J Public Health 58:5–10
Khokhar A (2012) Breast cancer in India: where do we stand and where do we go? Asian Pac J Cancer Prev 13:4861–4866
Keynes G (1928) Radium treatment of primary carcinoma of the breast. Lancet 2:108
Lichter AS, Lippman ME, Danforth DN Jr, d’Angelo T, Steinberg SM, deMoss E, MacDonald HD, Reichert CM, Merino M, Swain SM et al (1992) Mastectomy versus breast-conserving therapy in the treatment of stage I and II carcinoma of the breast: a randomized trial at the National Cancer Institute. J Clin Oncol 10:976–983
Van Dongen JA, Voogd AC, Fentiman IS, Legrand C, Sylvester RJ, Tong D et al (2000) Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst 92:1143–1150
Foster RS, Farwell ME, Costanza MC (1995) Breast-conserving care for breast cancer: patterns of care in a geographic region and estimation of potential applicability. Ann Surg Oncol 2:275–280
Morrow M, Bucci C, Rademaker A (1998) Medical contraindications are not a major factor in the underutilization of breast conserving therapy. J Am Coll Surg 186:269–274
Martin MA, Meyricke R, O’Neill T et al (2006) Mastectomy or breast conserving surgery? Factors affecting type of surgical treatment for breast cancer: a classification tree approach. BMC Cancer 6:98
Raina V, Bhutani M, Bedi R, Sharma A, Deo SV, Shukla NK et al (2005) Clinical features and prognostic factors of early breast cancer at a major centre in North India. Indian J Cancer 42:36–41
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386
Babu GR, Lakshmi SB, Thiyagarajan JA (2013) Epidemiological correlates of breast cancer in South India. Asian Pac J Cancer Prev 14:5077–5083
Ali I, Wani WA, Saleem K (2011) Cancer scenario in India with future perspectives. Cancer Ther 8:56–70
Rangarajan, Bharath et al. Breast cancer: an overview of published Indian data. South Asian J Cancer 2016. 5.3: 86–92
Chopra B, Kaur V, Singh K, Verma M, Singh S, Singh A (2014) Age shift: breast cancer is occurring in younger age groups—is it true? Clin Cancer Investig J 3:526–529
Narendra H, Ray S (2011) Breast surgery for breast cancer: single institutional experience from Southern India. Indian J Cancer 48:415–422
Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, Fisher E, Deutsch M, Caplan R, Pilch Y, Glass A, Shibata H, Lerner H, Terz J, Sidorovich L (1989) Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 320:822–828
Dinshaw KA, Budrukkar AN, Chinoy RF, Sarin R, Badwe R, Hawaldar R, Shrivastava SK (2005) Profile of prognostic factors in 1022 Indian women with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 63:1132–1141
Aziz Z, Sana S, Akram M, Saeed A (2004) Socioeconomic status and breast cancer survival in Pakistani women. J Pak Med Assoc 54:448–453
Raina V, Bhutani M, Bedi R, Sharma A, Deo SV, Shukla NK, Mohanti BK, Rath GK (2005) Clinical features and prognostic factors of early breast cancer at a major cancer center in North India. Indian J Cancer 42:40–45
Tewari M, Pradhan S, Kumar M, Shukla HS (2006) Effect of prevailing local treatment options of breast cancer on survival outside controlled clinical trials: experience of a specialist breast unit in North India. World J Surg 30:1794–1801
Hage JA, Velde CJ, Julien JP, Hulin MT, Vandervelden C, Duchateau L (2001) Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol 19:4224–4237
Parmar V, Krishnamurthy A, Hawaldar R, Nadkarni MS, Sarin R, Chinoy R, Nair R, Dinshaw KA, Badwe RA (2006) Breast conservation treatment in women with locally advanced breast cancer – experience from a single centre. Int J Surg 4:106–114
Aggarwal V, Agarwal G, Lal P, Krishnani N, Mishra A, Verma AK, Mishra SK (2007, Nov 21) Feasibility study of safe breast conservation in large and locally advanced cancers with use of radiopaque markers to mark pre-neoadjuvant chemotherapy tumor margins. World J Surg
Baron LF, Baron PL, Ackerman SJ, Durden DD, Pope TL (2000) Sonographically guided clip placement facilitates localization of breast cancer after neoadjuvant chemotherapy. AJR Am J Roentgenol 174:539–540
Desai SB, Moonim MT, Gill AK, Punia RS, Naresh KN, Chinoy RF (2000) Hormone receptor status of breast cancer in India: a study of 798 tumors. Breast 9:267–270
Jia H, Jia W, Yang Y, Li S, Feng H, Liu J, Rao N, Jin L, Wu J, Gu R, Zhu L, Chen K, Deng H, Zeng Y, Liu Q, Song E, Su F (2014) HER-2 positive breast cancer is associated with an increased risk of positive cavity margins after initial lumpectomy. World J Surg Oncol 12:289
Morrow M (2013) Personalizing extent of breast cancer surgery according to molecular subtypes. Breast 22(Suppl 2):S106–S109
Hughes KS, Schnaper LA, Berry D, Cirrincione C, McCormick B, Shank B, Wheeler J, Champion LA, Smith TJ, Smith BL, Shapiro C, Muss HB, Winer E, Hudis C, Wood W, Sugarbaker D, Henderson IC, Norton L, Cancer and Leukemia Group B, Radiation Therapy Oncology Group, Eastern Cooperative Oncology Group (2004) Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast cancer. N Engl J Med 351:971–977
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hassan Ali, S., S.P, S. & N, A. Rate of Breast-Conserving Surgery vs Mastectomy in Breast Cancer: a Tertiary Care Centre Experience from South India. Indian J Surg Oncol 10, 72–76 (2019). https://doi.org/10.1007/s13193-018-0818-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-018-0818-7