Surgical treatment of early stage breast cancer in Auckland and Waikato regions of New Zealand

29 September 2019

Ian Campbell, Chunhuan Lao, Tania Blackmore, Melissa Edwards, Louise Hayes, Alex Ng and Ross Lawrenson

Background
The aim of this study was to understand the factors influencing the use of surgical options by New Zealand wāhine/women with newly diagnosed breast cancer.

Methods
Using data from the Auckland and Waikato breast cancer registers, 11, 798 women diagnosed with stage I-III breast cancer from June 2000 to May 2013 were included. The characteristics of women receiving different surgical treatments and having immediate breast reconstruction following mastectomy were examined. A logistic regression was used to estimate the odds ratio of having breast-conserving surgery (BCS) versus mastectomy and immediate post-mastectomy reconstruction. Bilateral breast cancer cases and women with unilateral breast cancer, but who had bilateral surgery, were also identified.

Results
Fifty‐two percent of women received BCS and 44% had mastectomy over the study period. Key influences associated with BCS were age, mode of diagnosis, socio‐economic status and public or private treatment. Just under half of the women who underwent bilateral surgery did not have bilateral cancer. Nineteen percent of women undergoing mastectomy underwent immediate reconstruction. Implant use increased slightly over the study period but there was a decrease in the use of autologous flap procedures.

Conclusion
Surgical management of women with localized breast cancer was generally in line with guidelines, but with potential to further increase the use of breast conservation and immediate reconstruction in suitable cases.