In France 72% of patients had breast conservation surgery but in Poland it was only 2%. The figures come from an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries the Intergroup Exemestane Study. However, Professor Jacek Jassem, the cancer specialist who compiled and analysed the statistics, believes the results are representative of treatments generally in those countries.
Professor Jassem, who is head of the Department of Oncology and Radiotherapy at the Medical University of Gdansk in Poland, and the conference chairman, said that despite breast conserving surgery being widely accepted as a valuable alternative to mastectomy, the latter continues to be used as a main surgical approach.
"It is somewhat surprising," he said, "and I would consider it both a medical and a sociological phenomenon."
In the 37 countries overall, more than half the patients underwent mastectomy, nearly 40% had wide local excision of their tumour and 10% had some other form of breast conserving surgery.
The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.
The difference in surgery was despite the main clinical and therapeutic characteristics of the patients being well balanced in the two arms of the randomised global study, which was comparing the safety and efficacy of postoperative tamoxifen vs sequential tamoxifen and exemestane in postmenopausal women with operable breast cancer. The surgery involved was dependent on tumour characteristics, but otherwise had been left to the discretion o
Contact: Mary Rice
Federation of European Cancer Societies