Five and Ten Years Survival in Breast Cancer Patients Mastectomies vs. Breast Conserving Surgeries Personal Experience

Background: Breast carcinoma is the first malignancy among Iranian ladies and the second cause of death due to cancers after gastric carcinoma. According to the World Health Organization the annual incidence rate of breast cancer will rise 1.8 to 2 percent. It is one of the most important health problems. Five year survival is one of the indicators used for evaluation of the quality of care to different types of malignancies. In this study we decided to compare the result of mastectomy and breast conserving surgery in the survival of patients with breast carcinoma.

 Methods: This is a retrospective study using data from breast carcinoma cases in a private clinic under supervision of the author during years 1994 until 2007. These cases base on the clinical status underwent surgery as mastectomy or breast conserving with other necessary treatment. The number of patients with acceptable follow up was 464 cases that 441 were included to define survival. The data were analyzed by SPSS and survival estimated by Kaplan Mayer method.

Results: Survival curve was estimated for 441 cases of them, six cases were men and the age of patients was 22 to 104 years old with average of 53.24 years and standard deviation of 12.41. The most cases were among 45-55 years old. Five and ten years survival for all cases was 81 % and 77% respectively. These data for mastectomies patients was 78 and 70 percent and for breast preserving cases was 86 and 78 percent which was not significant in log rank test with p-value equally 0.13. There was no significant difference between mastectomies patients versus breast preserving cases in all clinical stages although the crude data shows better situation in breast preserving surgery (BPS).

Conclusion: Breast cancer is one of the most important health problems, nowadays breast preserving surgery is choice treatment for stage I and II throughout the world. In this study overall 5 years survival was 81% comparable with developed countries with different health delivery system and quality of care and it is much better than other reports from Iran, regional and comparable countries. Because of many reasons such as physical, social and psychological effect of BPS, we recommend it as the best choice for managing breast cancer patients in stage I and II and even III in clinically approved cases in Iran similar to other countries.