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High U.S. mastectomy rate reported in landmark trail: pegged at 51% for early-stage disease. (Contrary to NCI Recommendations).
SAN ANTONIO -- American women with early-stage breast cancer were 21% more likely to undergo mastectomy, compared with those from the United Kingdom in the largest clinical trial of breast cancer therapy ever conducted.
This is a disturbing finding because the National Cancer Institute has since the early 1990s endorsed breast-conserving therapy as the preferred approach whenever possible, Dr. Gerson Y. Locker said at a breast cancer symposium sponsored by the San Antonio Cancer Institute.
And the higher U.S. mastectomy rate in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) trial can't be explained by national differences in patient factors associated with increased likelihood of mastectomy Tumor size greater than 2 cm, the presence of four or more positive lymph nodes, age 70 years or greater, a poorly differentiated tumor, and other factors rendering a woman more likely to receive mastectomy rather than breast-conserving therapy were no more common in U.S. than U.K. participants in the trial, according to Dr. Locker of Northwestern University in Chicago.
Indeed, the prevalence of many promastectomy factors was, if anything, greater among U.K. enrollees. Yet the incidence of mastectomy among 2,222 Americans in ATAC was 51%, compared with 42% in the 3,228 U.K. participants.
Taking all factors favoring mastectomy or breast-conserving therapy into account in a multivariate analysis, simply being from the United States instead of the United Kingdom emerged as an independent risk factor, conferring a 44% greater likelihood of having a mastectomy in ATAC. ATAC involved 9,366 postmenopausal women with early-stage breast cancer treated at 320 medical centers in 81 nations during the late 1990s. Participants were randomized to adjuvant endocrine therapy with anastrozole (Arimidex), tamoxifen, or both. Anastrozole yielded superior disease-free survival, compared with the other two treatment regimens in women with hormone-sensitive ...
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Source: HighBeam Research, High U.S. mastectomy rate reported in landmark trail: pegged at 51%...