The declining use of axillary dissection in patients with early stage breast cancer

Xianglin Du, Jean L. Freeman, James Goodwin

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objectives: To determine any changes in usage of axillary dissection over time from 1983 to 1993, and to characterize those patients who do not receive axillary node dissection. Methods: A total of 129,946 female patients receiving cancer-directed surgery for early stage breast cancer, who were identified from the SEER (Surveillance, Epidemiology and End Results) program and diagnosed from 1983 to 1993, were included in the study. The surgical treatment and axillary dissection were based on treatment data collected by the SEER during the first course of therapy. Logistic regression analyses were used to assess the effect of patient and tumor characteristics on the likelihood of not receiving different types of treatment. Results: The percentage of women not receiving axillary dissection has increased over time, from 14.4% in 1983 to 16.8% in 1993. Nearly a quarter of women undergoing breast conserving surgery for local stage breast cancer receive neither axillary dissection nor radiotherapy. Older, unmarried, and non-white women and those with very small (< 0.5 cm) or very large (> 4 cm) tumors were most likely to receive neither axillary node dissection nor irradiation. Among those not receiving axillary dissection, 42% had tumors 1-3 cm in size and were not receiving radiation therapy. Conclusions: There is an apparent divergence between the type of patient who has been recommended as an appropriate candidate for avoiding axillary dissection (those with small tumors and those who will receive adjuvant therapy) and those who are actually not receiving axillary dissection in the community.

Original languageEnglish (US)
Pages (from-to)137-144
Number of pages8
JournalBreast Cancer Research and Treatment
Volume53
Issue number2
DOIs
StatePublished - 1999

Fingerprint

Dissection
Breast Neoplasms
Neoplasms
Radiotherapy
SEER Program
Therapeutics
Segmental Mastectomy
Epidemiology
Logistic Models
Regression Analysis

Keywords

  • Axillary node dissection
  • Breast cancer
  • Cancer-directed surgery
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

The declining use of axillary dissection in patients with early stage breast cancer. / Du, Xianglin; Freeman, Jean L.; Goodwin, James.

In: Breast Cancer Research and Treatment, Vol. 53, No. 2, 1999, p. 137-144.

Research output: Contribution to journalArticle

@article{bcd0d084b01045179ef408cab80c04fe,
title = "The declining use of axillary dissection in patients with early stage breast cancer",
abstract = "Objectives: To determine any changes in usage of axillary dissection over time from 1983 to 1993, and to characterize those patients who do not receive axillary node dissection. Methods: A total of 129,946 female patients receiving cancer-directed surgery for early stage breast cancer, who were identified from the SEER (Surveillance, Epidemiology and End Results) program and diagnosed from 1983 to 1993, were included in the study. The surgical treatment and axillary dissection were based on treatment data collected by the SEER during the first course of therapy. Logistic regression analyses were used to assess the effect of patient and tumor characteristics on the likelihood of not receiving different types of treatment. Results: The percentage of women not receiving axillary dissection has increased over time, from 14.4{\%} in 1983 to 16.8{\%} in 1993. Nearly a quarter of women undergoing breast conserving surgery for local stage breast cancer receive neither axillary dissection nor radiotherapy. Older, unmarried, and non-white women and those with very small (< 0.5 cm) or very large (> 4 cm) tumors were most likely to receive neither axillary node dissection nor irradiation. Among those not receiving axillary dissection, 42{\%} had tumors 1-3 cm in size and were not receiving radiation therapy. Conclusions: There is an apparent divergence between the type of patient who has been recommended as an appropriate candidate for avoiding axillary dissection (those with small tumors and those who will receive adjuvant therapy) and those who are actually not receiving axillary dissection in the community.",
keywords = "Axillary node dissection, Breast cancer, Cancer-directed surgery, Radiotherapy",
author = "Xianglin Du and Freeman, {Jean L.} and James Goodwin",
year = "1999",
doi = "10.1023/A:1006170811237",
language = "English (US)",
volume = "53",
pages = "137--144",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - The declining use of axillary dissection in patients with early stage breast cancer

AU - Du, Xianglin

AU - Freeman, Jean L.

AU - Goodwin, James

PY - 1999

Y1 - 1999

N2 - Objectives: To determine any changes in usage of axillary dissection over time from 1983 to 1993, and to characterize those patients who do not receive axillary node dissection. Methods: A total of 129,946 female patients receiving cancer-directed surgery for early stage breast cancer, who were identified from the SEER (Surveillance, Epidemiology and End Results) program and diagnosed from 1983 to 1993, were included in the study. The surgical treatment and axillary dissection were based on treatment data collected by the SEER during the first course of therapy. Logistic regression analyses were used to assess the effect of patient and tumor characteristics on the likelihood of not receiving different types of treatment. Results: The percentage of women not receiving axillary dissection has increased over time, from 14.4% in 1983 to 16.8% in 1993. Nearly a quarter of women undergoing breast conserving surgery for local stage breast cancer receive neither axillary dissection nor radiotherapy. Older, unmarried, and non-white women and those with very small (< 0.5 cm) or very large (> 4 cm) tumors were most likely to receive neither axillary node dissection nor irradiation. Among those not receiving axillary dissection, 42% had tumors 1-3 cm in size and were not receiving radiation therapy. Conclusions: There is an apparent divergence between the type of patient who has been recommended as an appropriate candidate for avoiding axillary dissection (those with small tumors and those who will receive adjuvant therapy) and those who are actually not receiving axillary dissection in the community.

AB - Objectives: To determine any changes in usage of axillary dissection over time from 1983 to 1993, and to characterize those patients who do not receive axillary node dissection. Methods: A total of 129,946 female patients receiving cancer-directed surgery for early stage breast cancer, who were identified from the SEER (Surveillance, Epidemiology and End Results) program and diagnosed from 1983 to 1993, were included in the study. The surgical treatment and axillary dissection were based on treatment data collected by the SEER during the first course of therapy. Logistic regression analyses were used to assess the effect of patient and tumor characteristics on the likelihood of not receiving different types of treatment. Results: The percentage of women not receiving axillary dissection has increased over time, from 14.4% in 1983 to 16.8% in 1993. Nearly a quarter of women undergoing breast conserving surgery for local stage breast cancer receive neither axillary dissection nor radiotherapy. Older, unmarried, and non-white women and those with very small (< 0.5 cm) or very large (> 4 cm) tumors were most likely to receive neither axillary node dissection nor irradiation. Among those not receiving axillary dissection, 42% had tumors 1-3 cm in size and were not receiving radiation therapy. Conclusions: There is an apparent divergence between the type of patient who has been recommended as an appropriate candidate for avoiding axillary dissection (those with small tumors and those who will receive adjuvant therapy) and those who are actually not receiving axillary dissection in the community.

KW - Axillary node dissection

KW - Breast cancer

KW - Cancer-directed surgery

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=0032928308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032928308&partnerID=8YFLogxK

U2 - 10.1023/A:1006170811237

DO - 10.1023/A:1006170811237

M3 - Article

VL - 53

SP - 137

EP - 144

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -