Open Access Research

The burden of breast cancer in Italy: mastectomies and quadrantectomies performed between 2001 and 2008 based on nationwide hospital discharge records

Prisco Piscitelli1, Maddalena Barba2, Massimo Crespi3, Massimo Di Maio4, Antonio Santoriello5, Massiliamo D’Aiuto6, Alfredo Fucito67, Arturo Losco8, Francesca Pentimalli9, Pasquale Maranta107, Giovanna Chitano11, Alberto Argentiero11, Cosimo Neglia11, Alessandro Distante11, Gian luca Di Tanna12, Maria Luisa Brandi1, Alfredo Mazza7, Ignazio R Marino13, Antonio Giordano101479* and on behalf of the Human Health Foundation Study Group, in memory of Prof. Giovan Giacomo Giordano

Author Affiliations

1 Department of Internal Medicine, University of Florence, Viale Pieraccini 18, Florence, 50139, Italy

2 Scientific Direction, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome , 00144, Italy

3 Epidemiology, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144 Rome, 00144, Italy

4 Local Health Authority of Naples (ASL NA1), Centro piazza Nazionale 95, Naples, 80143, Italy

5 Department of General Surgery, Second University of Naples, Via Sergio Pansini, Naples, 80131, Italy

6 Department of Senology, National Cancer Institute G. Pascale Foundation, Via Mariano Semmola, Naples, 80131, Italy

7 Sbarro Institute for Cancer Research and Molecular Medicine and Center of Biotechnology, College of Science and Technology Temple University, BioLife Science, Bldg. Suite 431 1900 N 12th Street, Philadelphia, PA, 19122, USA

8 Radiotherapy, Local Health Authority Salerno, via Nizza 146, Salerno, 84124, Italy

9 INT-CROM, National Cancer Institute G. Pascale Foundation - Cancer Research Center, Via Ammiraglio Bianco, Mercogliano, Avellino, 83013, Italy

10 Human Health Foundation, Piazza Pianciani 5, Spoleto-Perugia, 06049, Italy

11 Euro Mediterranean Biomedical Institute (ISBEM) Research Centre, Via Reali di Bulgaria, Brindisi, Mesagne, 72023, Italy

12 Department of Public Health and Infectious Diseases, La Sapienza University of Rome, Piazzale Aldo Moro 5, Rome, 00185, Italy

13 Department of Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA

14 Department of Human Pathology & Oncology, University of Siena, Strada delle Scotte, Siena, 53100, Italy

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Journal of Experimental & Clinical Cancer Research 2012, 31:96  doi:10.1186/1756-9966-31-96

Published: 20 November 2012

Abstract

Background

Where population coverage is limited, the exclusive use of Cancer Registries might limit ascertainment of incident cancer cases. We explored the potentials of Nationwide hospital discharge records (NHDRs) to capture incident breast cancer cases in Italy.

Methods

We analyzed NHDRs for mastectomies and quadrantectomies performed between 2001 and 2008. The average annual percentage change (AAPC) and related 95% Confidence Interval (CI) in the actual number of mastectomies and quadrantectomies performed during the study period were computed for the full sample and for subgroups defined by age, surgical procedure, macro-area and singular Region. Re-admissions of the same patients were separately presented.

Results

The overall number of mastectomies decreased, with an AAPC of −2.1% (−2.3 -1.8). This result was largely driven by the values observed for women in the 45 to 64 and 65 to 74 age subgroups (−3.0%, -3.4 -3.6 and −3.3%, -3.8 -2.8, respectively). We observed no significant reduction in mastectomies for women in the remaining age groups. Quadrantectomies showed an overall +4.7 AAPC (95%CI:4.5–4.9), with no substantial differences by age. Analyses by geographical area showed a remarkable decrease in mastectomies, with inter-regional discrepancies possibly depending upon variability in mammography screening coverage and adherence. Quadrantectomies significantly increased, with Southern Regions presenting the highest average rates. Data on repeat admissions within a year revealed a total number of 46,610 major breast surgeries between 2001 and 2008, with an overall +3.2% AAPC (95%CI:2.8-3.6).

Conclusions

In Italy, NHDRs might represent a valuable supplemental data source to integrate Cancer Registries in cancer surveillance.

Keywords:
Hospital discharge records; Breast cancer; Mastectomies; Quadrantectomies; Cancer surveillance