The need to diminish mastectomy rates in patients with breast cancer eligible for breast conservation

  • Alessandro FancelluEmail author
Letter to the Editor

Dear Editor,

I would like to bring attention to a topic of increasing interest in modern breast practice. Recent reports have shown that rates of mastectomy are on the rise in western countries [1]. This phenomenon would be seen as a contradiction for several reasons. In fact, the diagnosis of small and non-palpable tumours has become increasingly frequent by virtue of mammographic screening and breast cancer awareness among women. As a consequence, breast-conserving surgery can be considered as the treatment of choice in most cases. Moreover, the new techniques of oncoplastic surgery permit to perform breast-conserving treatment in some patients otherwise candidates to mastectomy [2]. However, there is now a shift from breast conservation toward a more aggressive approach, such as mastectomy, in a moment in which surgical treatment of solid tumours is becoming less invasive and targeted according to patients and tumours characteristics.

Rising mastectomy rates have been especially...


Compliance with ethical standards

Conflict of interest

The author declares that he has no conflict of interest.

Research involving human participants and/or animals

All procedures performed in the studies mentioned in the manuscript involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not applicable.


  1. 1.
    Fancellu A, Sanna V, Cottu P, Feo CF, Scanu AM, Farina G et al (2018) Mastectomy patterns, but not rates, are changing in the treatment of early breast cancer. Experience of a single European institution on 2315 consecutive patients. Breast 39:1–7CrossRefGoogle Scholar
  2. 2.
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  3. 3.
    Kummerow KL, Du L, Penson DF, Shyr Y, Hooks MA (2015) Nationwide trends in mastectomy for early-stage breast cancer. JAMA Surg 150:9e16CrossRefGoogle Scholar
  4. 4.
    Garcia-Etienne CA, Tomatis M, Heil J, Friedrichs K, Kreienberg R, Denk A, EUSOMA DB Working Group et al (2012) Mastectomy trends for early-stage breast cancer: a report from the EUSOMA multi-institutional European database. EurJ Cancer 48:56CrossRefGoogle Scholar
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    Hartmann-Johnsen OJ, Kåresen R, Schlichting E, Nygård JF (2015) Survival is better after breast conserving therapy than mastectomy for early stage breast cancer: a registry based follow-up study of Norwegian women primary operated between 1998 and 2008. Ann Surg Oncol 22:3836–3845CrossRefGoogle Scholar

Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  1. 1.Unit of General Surgery 2, Clinica Chirurgica, Department of Medical, Surgical and Experimental SciencesUniversity of SassariSassariItaly

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