Surgical treatment for women with breast cancer: Do randomized clinical trials represent current medical practices?

Wayne A I Frederick, Sarah Ames, Stephanie R. Downing, Tolulope A. Oyetunji, David C. Chang, Lasalle D. Leffall

Research output: Contribution to journalArticle

Abstract

Randomized clinical trials have not shown survival differences between breast cancer patients who undergo breast-conserving surgery and those who undergo modified radical mastectomy (MRM). Recent studies however, have suggested that these randomized clinical trials findings may not be representative of the entire population or the nature of current patient care. A retrospective analysis of female invasive breast cancer patients who underwent surgery in the Surveillance, Epidemiology, and End Results database (1990-2003) was performed. Survival was compared amongst women who underwent partial mastectomy, partial mastectomy plus radiation (PMR), or MRM. Cox proportional hazards regressions were used to investigate the impact of method of treatment upon survival, after adjusting for patient and tumor characteristics. A total of 218,043 patients, mean age 62 years, were identified. MRM accounted for 51.5 per cent of the study population whereas PMR accounted for 34.9 per cent. On multivariate analyses, significant improvement was observed in patient survival associated with PMR when compared with MRM patients (hazard ratio = 0.71, 95% confidence interval = 0.67-0.74, P <0.001). This population-based study suggests that there is a survival benefit for women undergoing PMR in the treatment of breast cancer.

Original languageEnglish (US)
Pages (from-to)630-636
Number of pages7
JournalAmerican Surgeon
Volume76
Issue number6
StatePublished - Jun 2010
Externally publishedYes

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Segmental Mastectomy
Modified Radical Mastectomy
Randomized Controlled Trials
Breast Neoplasms
Survival
Radiation
Therapeutics
Population
Patient Care
Epidemiology
Multivariate Analysis
Databases
Confidence Intervals
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Frederick, W. A. I., Ames, S., Downing, S. R., Oyetunji, T. A., Chang, D. C., & Leffall, L. D. (2010). Surgical treatment for women with breast cancer: Do randomized clinical trials represent current medical practices? American Surgeon, 76(6), 630-636.

Surgical treatment for women with breast cancer : Do randomized clinical trials represent current medical practices? / Frederick, Wayne A I; Ames, Sarah; Downing, Stephanie R.; Oyetunji, Tolulope A.; Chang, David C.; Leffall, Lasalle D.

In: American Surgeon, Vol. 76, No. 6, 06.2010, p. 630-636.

Research output: Contribution to journalArticle

Frederick, WAI, Ames, S, Downing, SR, Oyetunji, TA, Chang, DC & Leffall, LD 2010, 'Surgical treatment for women with breast cancer: Do randomized clinical trials represent current medical practices?', American Surgeon, vol. 76, no. 6, pp. 630-636.
Frederick WAI, Ames S, Downing SR, Oyetunji TA, Chang DC, Leffall LD. Surgical treatment for women with breast cancer: Do randomized clinical trials represent current medical practices? American Surgeon. 2010 Jun;76(6):630-636.
Frederick, Wayne A I ; Ames, Sarah ; Downing, Stephanie R. ; Oyetunji, Tolulope A. ; Chang, David C. ; Leffall, Lasalle D. / Surgical treatment for women with breast cancer : Do randomized clinical trials represent current medical practices?. In: American Surgeon. 2010 ; Vol. 76, No. 6. pp. 630-636.
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