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Multicentre prospective observational study evaluating recommendations for mastectomy by multidisciplinary teams

2019; Oxford University Press; Volume: 107; Issue: 3 Linguagem: Inglês

10.1002/bjs.11383

1365-2168

Jagdeep K Singh, Katherina McEvoy, Sekhar Marla, Daniel Rea, M. Hallissey, Adele Francis, Hiba Fatayer, Claire Murphy, Calver Pang, Kelvin Gomez, Valentina Lefemine, Muhammad Zaharan, C. Gateley, Philip A. Holland, Mohamed Farah Yusuf Mohamud, Julia Dicks, Shazia Khan, Nicola Day, Anita Sandi, Md Zaker Ullah, Mary L Venn, Dennis Wayne Chicken, Abdalla Saad Abdalla Al‐Zawi, Ali Salih, Ciara McGoldrick, Angela Volleamere, Chloe Wright, Rathi Rathinaezhil, Fiammetta Ugolini, Amit Agrawal, Yuriko Arima, John Benson, Parto Forouhi, Anuradha Apte, Arunmoy Chakravorty, Sankaran Chandrasekharan, Simon Marsh, Lesley Pennell, Claudia Harding-Mackean, Elizabeth Redmond, Joanna Seward, Sarah Laine, Gemma Pooley, Saed Ramzi, Irene Athanasiou, Olumuyiwa Olubowale, Clare Rogers, Nicola Wilkinson, Peter Crane, Harleen Deol, Neill Patani, Una Walsh, Jeremy J. Wood, Jonathan Keay, Chandeena Roshanlall, Veronika Pronisceva, Elizabeth Sharp, Elizabeth Clayton, Jordan Ford, Kavita Kanesalingam, Isabella Karat, Catriona Kemeny, Asaduzzaman Khan, Nikki Shah, Kevin Clark, Tani Fasih, Kishore Makam, R. Nangalia, Tin Sein, Asmaa Al‐Allak, James Bristol, Fiona Court, Clare Fowler, Richard Hunt, Charlotte Kallaway, Rebecca Llewellyn-Bennett, Eleanore Massey, Philippa Orchard, Sarah Vestey, Dimitrios Dragoumis, Siobhan Laws, Muhammad Qutayba Almerie, Biswajit Ray, Alia Hameed, Anwar Ul Haq, Rudwan Adi, Shaukat Mahmood Mirza, Elaine Gullaksen, Penelope McManus, Caroline Mortimer, Mary L Venn, Sarah Downey, Sandeep Joglekar, Kian Chin, Raju Kuzhively, Gazalla Safdar, Amanda Taylor, Sharat Chopra, Richard S. Johnson, Vummiti Murali Krishnan, Laura Arthur, Caroluce Musyoka, Nick Abbott, Jennifer Pollard, Kate Fitzgerald, Alison Lannigan, Debbie McCrone, Keith McGarry, Jayne McGivern, Clare McKenzie, Dermot Murphy, Juliette Murray, Samiya Al-Hattali, E. Jane Macaskill, Rachel Ainsworth, Isabella Dash, Tanvir Ahmad, J Groome, Charlotte Moon, Niroshini Rajaretnam, Elaine Heaney, Brendan McFall, Sunil Amonkar, Sebastian Aspinall, Michael J. Carr, Karen L. Edwards, Helen Elliott, Lynn Mann, Laura J. Spence, Amanda Walshe, Magdi Yousef, Malin Akerlund, Kym Bignell, Lisa Brock, Jennett Kelsall, Charlene Otieno, Lisa Whisker, Nick Battersby, Abigail T. Evans, James Harvey, Amit Agrawal, Masooma Zaidi, Mohamed Al-Gailani, Inder D Kumar, Emma MacInnes, Douglas Ferguson, Sara Green, Mina Youssef, Oroog Ali, Fiona Hoar, Katherina McEvoy, Ian Rea, Sadaf Jafferbhoy, Blossom Lake, Hammad Sheikh, Peter Donnelly, Michael J. Green, Charlotte Ives, Samantha Minto, Gareth Irwin, Stephen Kirk, Dayalan Clarke, Debbie Enser, Simon Harries, Lucie Jones, Habib Tafazal, Leena Chagla, Ramesh Hodigere, Tamara Kiernan, Manik Chana, Amanda Thorne, T.G. Walker, Hilary Croydon, Jagdeep K Singh, David Archampong, Laura Johnson, Rosa Di Micco, Rachel O’Connell, Caroline Richardson, Jennifer Rusby, Ludka Soldanova, Brian Isgar, Pilar Matey, Senthurun Mylvaganam, Zaid Raouf, Fathi Salem, Tapan Sircar, Raghavan Vidya, A Gvaramadze, Amtul Sami, Dinesh Thekkinkattil, Nicholas Turner, Tracey Lechi, Stuart Robertson, Ibrahim Al Waili, Adele Francis, Laura Magill, Sekhar Marla, Rita Perry, Margaret Wilcox, Soofiyah Ayaani, S Dean, Mohammed Mahmood, Abigail Tomlins, Donna Appleton, Monika Kaushik, Hazem Khout, Giuseppina Mondani, Simon Pilgrim, Tim Rattay, Shahid Gilani, Sankaran Narayanan, Soni Soumian, Megha Tandon, Phil Brookes, Henry J.M. Ferguson, Jenni Gaughan, Marlies Heitmann, Mohd Iqbal, Jane Aitken, Olubunmi Odofin, Wosu Chukwuemeka, Dibendu Betal, Riccardo Bonomi, Rachel Ainsworth, Isabella Dash, Chiara Rossi, Karen James, Raman Vinayagam, Elizabeth A. Baker, Amrita Chandra, Baek Kim, Kailas Munot, Rana Nasr, Jenny Piper,

BRCA gene mutations in cancer

Abstract Background Recommendations for mastectomy by multidisciplinary teams (MDTs) may contribute to variation in mastectomy rates. The primary aim of this multicentre prospective observational study was to describe current practice in MDT decision-making for recommending mastectomy. A secondary aim was to determine factors contributing to variation in mastectomy rates. Methods Consecutive patients undergoing mastectomy between 1 June 2015 and 29 February 2016 at participating units across the UK were recruited. Details of neoadjuvant systemic treatment (NST), operative and oncological data, and rationale for recommending mastectomy by MDTs were collected. Results Overall, 1776 women with breast cancer underwent 1823 mastectomies at 68 units. Mastectomy was advised by MDTs for 1402 (76·9 per cent) of these lesions. The most common reasons for advising mastectomy were large tumour to breast size ratio (530 women, 29·1 per cent) and multicentric disease (372, 20·4 per cent). In total, 202 postmenopausal women with oestrogen receptor-positive (ER+) unifocal tumours were advised mastectomy and not offered NST, owing to large tumour to breast size ratio in 173 women (85·6 per cent). Seventy-five women aged less than 70 years with human epidermal growth factor receptor 2-positive (HER2+) tumours were advised mastectomy and not offered NST, owing to large tumour to breast size ratio in 45 women (60 per cent). Conclusion Most mastectomies are advised for large tumour to breast size ratio, but there is an inconsistency in the use of NST to downsize tumours in patients with large ER+ or HER2+ cancers. The application of standardized recommendations for NST could reduce the number of mastectomies advised by MDTs.