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Variabilidad en la utilización del tratamiento conservador del cancer de marna localizado en un área geográfica

Variability in the use of breast conserving surgery for localized breast cancer in a geographical area

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Abstract

Objetivos

Conocer el porcentaje de tratamiento conservador del cancer de marna en estadios I y II en un área geográfica, la variabilidad de indicación entre diferentes centros y los posibles factores relacionados.

Métodos

En un estudio de corte transversal retrospectivo se recogieron un total de 225 casos de cáncer de marna en estadios iniciales y se determinó el tipo de cirugía (conservadora o mastectomía) y su relación con posibles predictores de la misma.

Resultados

La frecuencia de conservación mamaria fue del 27% para el conjunto de casos (IC del 95%, 22–34%). En el estadio I se realizó en el 49% de casos y en el estadio II en el 21%. La probabilidad de ser tratada con tratamiento conservador no pudo establecerse ni con la edad de la paciente ni con el área de residencia rural o urbana, pero si de forma significativa con el centro de tratamiento y el estadio.

Conclusiones

La menor frecuencia de conservación en estadio II no se ajusta en nuestro medio a los estándares aceptados. Factores propios de cada centro o del cirujano que atiende a la paciente pueden explicar la variabilidad en la frecuencia de indicación de conservación mamaria entre ellos.

Abstract

Objectives

To determine the percentage of breast conservation surgery in patients with stage I and stage II breast cancer carried out in a geographic area, the variability in treatment among different centers and the possible factors associated with the choice of this type of procedure as opposed to another.

Material and methods

Retrospective transversal study of 225 patients with early-stage breast cancer. The patients were reviewed to determine the type of surgery carried out (breast conserving or mastectomy). The possibility of a relationship between the type of surgery performed and associated variables was also evaluated.

Results

The total frequency of breast conserving treatment was 27% (95% CI, 22%–24%). This type of treatment was carried out in 49% of patients with stage I cancer and 21% of those with the stage II cancer. The probability of being treated with breast conserving surgery was not found to be related to patient age or to rural or urban residence but was significantly related to the treatment center and to tumor stage.

Conclusions

The lower frequency of breast conserving therapy in stage II is not directly related to established clinical practice guidelines. Other factors such as the treatment center or the surgeon’s preference for one type of treatment are possible explanations for the degree of variation observed in breast conserving procedures.

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Correspondence to Lorenzo Alonso.

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Alonso, L., González-Valentín, A., Abarca, M. et al. Variabilidad en la utilización del tratamiento conservador del cancer de marna localizado en un área geográfica. Rev Oncología 2, 202–206 (2000). https://doi.org/10.1007/BF02979555

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Palabras clave

  • Cáncer de marna
  • Tratamiento conservador
  • Variabilidad de tratamiento

Key words

  • Breast cancer
  • Breast conserving treatment
  • Treatment variability