Breast Cancer Surgery in Canada

• In 2012, roughly 22,700 women were diagnosed with invasive breast cancer.
• Substantial variations exist in the use of surgical breast cancer treatments across the country.
• Mastectomy and breast-conserving surgery (BCS, commonly known as a lumpectomy) are two types of surgery used to treat invasive cancer and the non-invasive form of the disease (ductal carcinoma in situ, DCIS).
  • Both treatment options present little risk of complications: from 2007–2008 to 2009–2010, 7-day and 30-day complication rates were 2% or less for BCS, and 6% or less for mastectomy for both invasive breast cancer and DCIS).
• For women diagnosed with smaller tumours, evidence shows that BCS followed by radiation treatment provides a survival rate comparable to mastectomy.
• Crude mastectomy rates varied greatly across Canada, ranging from 26% in Quebec to 69% in Newfoundland and Labrador
• From 2007–2008 to 2009–2010, 23% of women with invasive breast cancer and 36% of women with DCIS required at least one additional operation following the initial BCS.
  • Of the 23% with invasive breast cancer, 11% underwent mastectomies while 12% underwent further BCS.
  • Newfoundland and Labrador demonstrated the highest re-excision rate following BCS, at 56%. Manitoba's and Quebec's re-excision rates following BCS were lower, at 17%.
• There tends to be a U-shaped relationship between age and mastectomy rates.
  • Mastectomy rates were relatively high (44%) for women age 18 to 49. Rates then fell to 35% for those age 50 to 69 and rose again to 45% for women age 70 and older.
• There tends to be an increase in mastectomy rates corresponding to travel time greater than 40 minutes between a woman's home and the cancer centre offering radiation treatment.
  • Mastectomy rates exceeded 50% for women who must travel 1.5 hours or longer each way to reach a centre offering radiation treatment.

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