• Alessandro Fancellu, Valeria Sanna, Pietrina Cottu, Cladio F Feo, Antonio M Scanu, Giulia Farina, Antonio Bulla, Angela Spanu, Panagiotis Paliogiannis, and Alberto Porcu.
• Unit of General Surgery 2-Clinica Chirurgica, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. Electronic address: afancel@uniss.it.
• Breast. 2018 Jun 1; 39: 1-7.

BackgroundRecent literature reports that rates of mastectomy are increasing in early breast cancer. However, data from European institutions are limited and revealed conflicting results. We report on 15-year trends of mastectomy, mastectomy plus immediate reconstruction and contralateral prophylactic mastectomy (CPM) at an academic institution.MethodsWe identified women diagnosed with unilateral early breast cancer at stage 0-IIa, with tumour size ≤ 4 cm, between 2002 and 2016. Trends were assessed using the Cochrane-Armitage test. Multivariable logistic regression was used to identify factors associated with receipt of mastectomy plus immediate reconstruction.ResultsA total of 2315 patients were identified. Of them, 65.7% underwent breast conserving surgery (BCS), while 34.3% underwent mastectomy as upfront surgery. Two point four per cent also received CPM. Immediate reconstruction was performed in 36.0% of patients receiving mastectomy. There was no change in trends of mastectomy over the 15 years studied (p = 0.69), as well as in trends of patients undergoing CPM (p = 0.44). In contrast, rates of immediate reconstruction rose significantly over the study period (from 12.2% in 2002 to 62.7% in 2016, p < 0.0001). Women were more likely to receive mastectomy plus immediate reconstruction if they were aged 50 years or younger, or had tumours larger than 2 cm, or had non-invasive carcinoma.ConclusionsOur study suggests that rates of both mastectomy and CPM in early breast cancer are not increasing, while use of immediate reconstruction is on the rise.Copyright © 2018 Elsevier Ltd. All rights reserved.

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