• Débora Balabram, Fábio Braga Araújo, Simone Souza Porto, Joyce Soares Rodrigues, Atila Silva Sousa, Arminda Lucia Siqueira, and Helenice Gobbi.
• Department of Anatomical Pathology, Universidade Federal de Minas Gerais, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
• Sao Paulo Med J. 2012 Jan 1; 130 (6): 360366360-6.

Context And ObjectiveRecently, breast-conserving surgery (BCS) has been replacing mastectomy for breast cancer treatment. The aim of this study was to evaluate the changes in mastectomy and BCS rates and the factors relating to these shifts.Design And SettingA retrospective study in a Brazilian public hospital.MethodsPathological records from female patients who underwent surgery for breast cancer at Hospital das Clínicas, Universidade Federal de Minas Gerais (HC-UFMG), between 1989 and 2008 were reviewed. The mastectomy and BCS rates were calculated. The chi-square test was used to assess factors associated with type of surgical treatment and to compare trends in treatment type over the years. Logistic regression was used for multivariate analysis.ResultsFrom 1989 to 2008, 2050 breast cancer surgical specimens were received in our service, corresponding to 1973 patients; 1324 (64.6%) of them were from mastectomy and 726 (35.4%) from BCS. A shift from mastectomy towards BCS was observed (P < 0.001). In multivariate analysis, earlier year of surgery (P < 0.001), larger tumor size (P < 0.001), having at least one positive axillary lymph node (P < 0.001) and patients' age greater than 68 years (P = 0.007) were predictors of mastectomy.ConclusionsThere was a shift from mastectomy towards BCS in our institution over the years. This may reflect consolidation of BCS (plus radiotherapy) as an equivalent treatment to mastectomy in terms of survival and a shift to earlier diagnosis for the disease.

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