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. 2009 Sep 1;27(25):4082-8.
doi: 10.1200/JCO.2008.19.4225. Epub 2009 Jul 27.

Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging

Rajini Katipamula  1 , Amy C Degnim, Tanya Hoskin, Judy C Boughey, Charles Loprinzi, Clive S Grant, Kathleen R Brandt, Sandhya Pruthi, Christopher G Chute, Janet E Olson, Fergus J Couch, James N Ingle, Matthew P Goetz
Affiliations

Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging

Rajini Katipamula et al. J Clin Oncol. .

Abstract

Purpose: Recent changes have occurred in the presurgical planning for breast cancer, including the introduction of preoperative breast magnetic resonance imaging (MRI). We sought to analyze the trends in mastectomy rates and the relationship to preoperative MRI and surgical year at Mayo Clinic, Rochester, MN.

Patients and methods: We identified 5,405 patients who underwent surgery between 1997 and 2006. Patients undergoing MRI were identified from a prospective database. Trends in mastectomy rate and the association of MRI with surgery type were analyzed. Multiple logistic regression was used to assess the effect of surgery year and MRI on surgery type, while adjusting for potential confounding variables.

Results: Mastectomy rates differed significantly across time (P < .0001), and decreased from 45% in 1997% to 31% in 2003, followed by increasing rates for 2004 to 2006. The use of MRI increased from 10% in 2003% to 23% in 2006 (P < .0001). Patients with MRI were more likely to undergo mastectomy than those without MRI (54% v 36%; P < .0001). However, mastectomy rates increased from 2004 to 2006 predominantly among patients without MRI (29% in 2003% to 41% in 2006; P < .0001). In a multivariable model, both MRI (odds ratio [OR], 1.7; P < .0001) and surgical year (compared to 2003 OR: 1.4 for 2004, 1.8 for 2005, and 1.7 for 2006; P < .0001) were independent predictors of mastectomy.

Conclusion: After a steady decline, mastectomy rates have increased in recent years with both surgery year and MRI as significant predictors for type of surgery. Further studies are needed to evaluate the role of MRI and other factors influencing surgical planning.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
Proportion of patients undergoing mastectomy from 1997 to 2006; vertical bars represent 95% CIs for the estimated proportion.
Fig 2.
Fig 2.
Proportion of patients undergoing preoperative breast magnetic resonance imaging from 2003 to 2006; vertical bars represent 95% CIs for the estimated proportion.
Fig 3.
Fig 3.
Proportion of patients undergoing mastectomy from 2003 to 2006 according to utilization of preoperative magnetic resonance imaging; vertical bars represent 95% CIs for the estimated proportion.
See this image and copyright information in PMC

Comment in

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