Evaluation of Eligibility and Utilization of Breast Conservation Treatment in an Asian Context


Background: Breast conservation treatment (BCT) has long been recognised to provide survival outcomesequivalent to mastectomy for the treatment of breast cancer. However, published reports of BCT rates in Asiancommunities are lower than those from Western countries. This study sought to investigate the eligibility andutilisation of BCT in a predominantly Asian population. Materials and
Methods: All patients treated surgicallyby a single surgeon at a private medical facility between 2009 and 2011 were included in the study. Patients weredeemed to have successful BCT if they underwent breast conserving surgery with pathologic clear margins andcompleted all recommended adjuvant treatment. Those who did not complete adjuvant treatment were excludedfrom the analysis.
Results: Data from a total of 161 patients who underwent treatment during the study periodwere analysed. The mean age was 48.8 years. One hundred and six patients (65.8%) were of Chinese ethnicity,12 were Indian (7.5%), 11 were Malay (6.8%), 18 were Caucasian (11.2%) and 14 (8.7%) were of other Asianethnicity. One hundred and thirty-eight women (85.7%) underwent BCT. Of the 23 (14.3%) who underwentmastectomy, 8 (5.4%) elected to undergo a mastectomy despite being eligible for BCT. In total, it was assessedthat 146 of 161 patients (90.7%) were eligible for BCT and utilisation was 94.5%.
Conclusions: In this study,eligibility, utilisation of BCT and eventual successful breast conservation rates are similar to published ratesin Western communities. Additional research is needed to investigate the reasons for the lower published BCTrates in Asian countries and determine ways to improve them.