The burden of breast cancer in Italy: mastectomies and quadrantectomies performed between 2001 and 2008 based on nationwide hospital discharge records
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
Journal of Experimental & Clinical Cancer Research 2012, 31:96 doi:10.1186/1756-9966-31-96Published: 20 November 2012
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.
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.
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).
In Italy, NHDRs might represent a valuable supplemental data source to integrate Cancer Registries in cancer surveillance.