Surgical Trends in Breast Cancer in Turkey: An Increase in Breast-Conserving Surgery
Author
Kuru, Bekir
Cakmak, Gueldeniz Karadeniz
Emiroglu, Selman
Sezer, Atakan
Cantürk, Nuh Zafer
Yeniay, Levent
Karanlik, Hasan
Soyder, Aykut
Gokgoz, Sehsuvar
Sakman, Gürhan
Ucuncu, Muhammed
Akçay, Müfide Nuran
Girgin, Sadullah
Özkan Gürdal, Sibel
Emiroglu, Mustafa
Ozbas, Serdar
Öz, Abdullah Bahadır
Arıcı, Cumhur
Toktaş, Osman
Demircan, Orhan
Çalık, Adnan
Polat, Ayfer Kamalı
Maralcan, Göktürk
Demirer, Seher
Ozmen, Vahit
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PURPOSEBreast cancer is the most frequent cancer in women, and there is a great variability in surgical practice for treating that cancer in different countries. The aims of this study were to analyze the effect of guidelines from the Turkish Federation of Breast Diseases Societies on academic institutions that have breast centers and to evaluate surgical practice in Turkey in 2018.PATIENTS AND METHODSBetween January and March 2019, a survey was sent to breast surgeons who were working in breast centers in academic institutions. The sampling frame included 24 academic institutions with breast centers in 18 cities in Turkey to evaluate interdisciplinary differences among breast centers and seven regions in Turkey regarding patients' choices, surgical approaches, and academic institutions.RESULTSAll surgeons responded to the survey, and all 4,381 patients were included. Most of the surgeons (73.9%) were working in a breast center. Multidisciplinary tumor boards were performed in 87% of the breast centers. The average time between clinical evaluation and initiation of treatment was 29 days; the longest time was in Southeast Anatolia (66 days). Only 6% of patients had ductal carcinoma in situ. Sentinel lymph node biopsy was available in every region across the country and was performed in 64.5% of the patients. In 2018, the overall breast-conserving surgery rate was 57.3% in Turkey, and it varied from 72.2% in the Black Sea region to 33.5% in Central Anatolia (P < .001). Oncoplastic breast surgery options were available at all breast centers. However, 25% of the breast centers from the Black Sea region and half the breast centers from Eastern Anatolia and the Mediterranean region did not perform this type of surgery.CONCLUSIONIncreasing rates of nonpalpable breast cancer and decreasing rates of locoregional recurrences favored breast-conserving surgery, especially in developed countries. Guidelines from the Turkish Federation of Breast Diseases Societies resulted in more comprehensive breast centers and improved breast health in Turkey.
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