Factors that are Effective in Surgery Preferences of Patients Diagnosed with Breast Cancer who are Admitted to Radiation Oncology Clinics

OBJECTIVEIn this study, the factors affecting the choice of treatment were investigated in patients diagnosed withbreast cancer who were treated with breast-conserving surgery or mastectomy.METHODSFactors that may be effective in surgical choice were aimed to be determined by retrospectively examining patient files regarding age, pathological type, diameter and lateralization of the tumor, number oflymph nodes in the axilla, estrogen and progesterone receptor (ER and PR), c-erbB-2 status, the place ofresidence, center of operation and distribution of patients according to years. The relationships amongthe data in this study were examined using statistical methods.RESULTSThe mean age of the patients was 52.06±11.91 (age range: 28–86). Tumor lateralization was the right sidein 44.4% of the patients and the left side in 55.6% of the patients. There were significantly more modified radical mastectomy (MRM) surgeries in the cases with left-sided lateralization and more breastconserving surgeries (BCS) in the patients with right-sided lateralization (p=0.001). Significantly moreBCSs were found to be performed when the tumor diameter was less than 2.5 cm, and more MRMswere performed as the nodal stage increased (p=0.000, p

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1. Halsted WS. I. A Clinical and Histological Study of certain Adenocarcinomata of the Breast: and a Brief Consideration of the Supraclavicular Operation and of the Results of Operations for Cancer of the Breast from 1889 to 1898 at the Johns Hopkins Hospital. Ann Surg. 1898;28(5):557-–76.
2. Fisher B, Fisher ER. Transmigration of lymph nodes by tumor cells. Science 1966;152(3727):1397–8.
3. Fisher B, Fisher ER. The interrelationship of hematogenous and lymphatic tumor cell dissemination. Surg Gynecol Obstet 1966;122(4):791–8.
4. Fisher B, Anderson SJ. The breast cancer alternative hypothesis: is there evidence to justify replacing it? J Clin Oncol 2010;28(3):366–74.
5. Cardoso F, Senkus E, Costa A, Papadopoulos E, Aapro M, André F, et al. 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†. Ann Oncol 2018;29(8):1634–57.
6. Franceschini G, Martin Sanchez A, Di Leone A, Magno S, Moschella F, Accetta C, et al. New trends in breast cancer surgery: a therapeutic approach increasingly efficacy and respectful of the patient. G Chir 2015;36(4):145–52.
7. Keynes G. Conservative Treatment of Cancer of the Breast. Br Med J 1937;2(4004):643–66.3.
8. Veronesi U, Luini A, Del Vecchio M, Greco M, Galimberti V, Merson M, et al. Radiotherapy after breastpreserving surgery in women with localized cancer of the breast. N Engl J Med 1993;328(22):1587–91.
9. Litière S, Werutsky G, Fentiman IS, Rutgers E, Christiaens MR, Van Limbergen E, et al. Breast conserving therapy versus mastectomy for stage I-II breast cancer: 20 year follow-up of the EORTC 10801 phase 3 randomised trial. Lancet Oncol 2012;13(4):412–9.
10.Fisher B, Anderson S, Redmond CK, Wolmark N, Wickerham DL, Cronin WM. Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Eng J Med 1995;333(22):1456–61.
11.Lazovich D, White E, Thomas DB, Moe RE. Underutilization of breast-conserving surgery and radiation therapy among women with stage I or II breast cancer. JAMA 1991;266(24):3433–8.
12.Young WW, Marks SM, Kohler SA, Hsu AY. Dissemination of clinical results: mastectomy versus lumpectomy and radiation therapy. Med Care 1996;34(10):1003–17.
13.Farrow DC, Hunt WC, Samet JM. Geographic variation in the treatment of localized breast cancer. N Engl J Med 1992;326(17):1097–101.
14.Athas WF, Adams-Cameron M, Hunt WC, Amir-Fazli A, Key CR. Travel distance to radiation therapy and receipt of radiotherapy following breast-conserving surgery. J Natl Cancer Inst 2000;92(3):269–71.
15.Mann BA, Samet JM, Hunt WC, Key CR, Goodwin JM, Goodwin JS. Changing treatment of breast cancer in New Mexico from 1969 through 1985. JAMA 1988;259(23):3413–7.
16.Colleoni M, Rotmensz N, Robertson C, Orlando L, Viale G, Renne G, et al. Very young women (<35 years) with operable breast cancer: features of disease at presentation. Ann Oncol 2002;13(2):273–9.
17. van Nes JG, van de Velde CJ. The preferred treatment for young women with breast cancer--mastectomy versus breast conservation. Breast 2006;15 Suppl 2:S3–10.
18.Gentilini O, Botteri E, Rotmensz N, Toesca A, De Oliveira H, Sangalli C, et al. Breast-conserving surgery in 201 very young patients (<35 years). Breast 2010;19(1):55–8.
19.Busk T, Clemmesen J. The frequencies of left- and rightsided breast cancer. British J Cancer 1947;1(4):345–51.
20.Darby SC, McGale P, Taylor CW, Peto R. Long-term mortality from heart disease and lung cancer after radiotherapy for early breast cancer: prospective cohort study of about 300,000 women in US SEER cancer registries. Lancet Oncol 2005;6(8):557–65.
21.Weiss HA, Devesa SS, Brinton LA. Laterality of breast cancer in the United States. Cancer Causes Control 1996;7(5):539–43.
22.Cuzick J, Stewart H, Rutqvist L, Houghton J, Edwards R, Redmond C, et al. Cause-specific mortality in long-term survivors of breast cancer who participated in trials of radiotherapy. J Clin Oncol 1994;12(3):447–53.
23.Favourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists' Collaborative Group. Lancet 2000;355(9217):1757–70.
24.Köksal M, Doğan S, Öztürk F, Cücer N. Investigation of the Relationship Between the Largest Tumor Size, AgNOR area and AgNOR Count on Breast Cancer Cells. Journal of Natural and Applied Sciences 2016;32(2).
25.Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V. Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the socalled triple-negative phenotype: a population-based study from the California cancer Registry. Cancer 2007;109(9):1721–8.
26.Andersen LD, Remington PL, Trentham-Dietz A, Robert S. Community trends in the early detection of breast cancer in Wisconsin, 1980-1998. Am J Prev Med 2004;26(1):51–5.
27.Li CI, Anderson BO, Daling JR, Moe RE. Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA 2003;289(11):1421–4.
28.Gültekin M, Boztaş G. Türkiye Kanser İstatistikleri, Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu. Ankara: 2014.