Mastectomy Rates All Over the Map

Large disparity between countries in how many are performed

FRIDAY, March 19, 2004 (HealthDayNews) -- There's huge variation between countries in their rates of conservation surgery for breast cancer, says a study presented March 19 at the European Breast Cancer Conference.

France had the highest breast conservation rate at 72 percent, while Poland ranked last at 2 percent. Researchers analyzed surgical techniques used in an international trial of adjuvant treatment among 4,700 women with breast cancer in 37 countries.

Overall, more than 50 percent of the 4,700 patients in the 37 countries underwent mastectomy, nearly 40 percent had wide local excision of their tumor, and 10 percent had some other form of breast-conserving surgery.

Central and eastern Europe had the highest mastectomy rate at 77 percent. The United States had the second highest mastectomy rate at 56 percent. The average rate for western and northern Europe was 46 percent; southern Europe, 42 percent; and Australia and New Zealand; 34 percent.

Cancer specialist Jacek Jassem of the Medical University of Gdansk, Poland, compiled and analyzed the data. He notes that despite the fact that breast-conserving surgery is widely accepted as a valuable alternative to mastectomy, the latter remains the main surgical treatment for breast cancer.

"It is somewhat surprising and I would consider it both a medical and sociological phenomenon," Jassem says in a prepared statement.

He says that in countries with higher mastectomy rates, breast tumors may be more advanced by the time they are found.

"Early detection is strictly related to screening programs, and in countries with no nationwide screening programs the cancer is likely to be more advanced on average at diagnosis. We can't take tradition and surgeons' and patients' attitudes into account in the analysis, but this may be another factor. Finally, in some countries, access to radiotherapy may be an issue," Jassem says.

Here are some country-by-country mastectomy rates from the study:

  • Poland 98 percent.
  • Spain 66 percent.
  • United States 56 percent.
  • The Netherlands 48 percent.
  • Switzerland 47 percent.
  • Germany 43 percent.
  • Italy 41 percent.
  • Belgium 37 percent.
  • England 31 percent.
  • France 28 percent.

More information

The U.S. National Cancer Institute has more about breast cancer treatment.

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